| Summary points: | A 43-year-old Nigerian female was referred for features of hyperthyroidism from a psychiatric hospital where she was hospitalised for 4 weeks on account of an 8-month history of violent behaviour and a 2-month history of isolation, poor sleep, talking and laughing to self, threatening to harm neighbours, poor personal hygiene, and weight loss. Other observations and symptoms, medical history, clinical examination, central nervous system examination, initial mental state examination, chest and abdominal examination, thyroid function tests, thyroid ultrasound scan, laboratory data, and treatment are described. The authors discuss a rare case of Graves' disease presenting as paranoid schizophrenia. |