Neuropsychiatric manifestations of Graves’ disease with a focus on depression anxiety and psychiatric comorbidities
Graves’ disease (GD), an autoimmune thyroid disorder, is a common cause of hyperthyroidism and is frequently associated with neuropsychiatric symptoms such as depression and cognitive impairment. Despite this, mental health concerns remain overlooked in GD management guidelines. This review evaluates the neuropsychiatric effects of GD, highlighting the need for integrated treatment approaches, underlying processes, and its link to depression. A literature-based analysis was conducted, focusing on the pathophysiological links between GD and psychiatric manifestations, particularly depression. GD alters inflammatory cytokines, affects neurotransmitter metabolism, increases blood-brain barrier permeability, and causes hormonal dysregulation, all of which contribute to the development of depression. Gut microbiota imbalance also influences the gut-brain axis, playing a role in cognitive and mood disturbances. GD-related eating disorders further impact patient outcomes. Conventional treatments, including antithyroid drugs, selective serotonin reuptake inhibitors (SSRIs), β-blockers, and in some cases, electroconvulsive therapy (ECT), have shown efficacy in managing both thyroid and psychiatric symptoms. Psychological interventions and probiotics offer additional support. Graves’ disease has a significant neuropsychiatric aspect that requires routine mental health evaluation and integrated treatment. Addressing psychological symptoms alongside endocrine therapy improves patient quality of life and outcomes. Future research should further elucidate the mechanisms connecting GD and mental illness to enhance patient-centered care.