[Case Report] 46yo with psychosis and cold intolerance

A 46-year old man is admitted to hospital following a first time presentation of psychosis that involved barricading himself inside a neighbour’s home. At admission he appears disorganised with slow movements and speech. His rambling reveals bizarre delusional beliefs of a paranoid and persecutory nature. At moments he shows aggression towards staff but when examines reports occasional dizziness and an intolerance of cold. Physical examination reveals cool peripheries, sparse axillary and pubic hair, and soft adult-sized testicles. The investigating team suspect hypothyroidism and a complex series of investigations and therapies follows.

Guests
Dr Peak Man Mah FRACP  (Lyell McEwin Hospital, University of Adelaide)
Dr Malcolm Borg (Royal Adelaide Hospital)
 
Hosts
Associate Professor Stephen Bacchi FRACP (Lyell McEwin Hospital; University of Adelaide)
Mic Cavazzini DPhil

Production
Produced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin’ for Decades’ by Blue Texas and ‘Brighton Breakdown’ by BDBs. Image created and copyrighted by RACP. 

Editorial feedback kindly provided by RACP physician Simeon Wong and medical student Cindy Shi. 
 

Key Reference (Spoiler Alert)

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Panhypopituitarism and psychosis in a male patient [Aust N Z J Psychiatry. 2010]

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