Meeting abstract

https://doi.org/10.24869/spsih.2026.312

Is Lithium the “Culprit”? – A Case Report of a Patient With Comorbid Bipolar Affective Disorder and Hashimoto Thyroiditis

Jelena Rebić ; Clinic for Psychiatry, Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia; Department of Psychiatry and Psychological Medicine, Faculty of Medicine in Rijeka, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia *
Tanja Grahovac Juretić ; Clinic for Psychiatry, Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia; Department of Psychiatry and Psychological Medicine, Faculty of Medicine in Rijeka, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
Marina Letica Crepulja ; Clinic for Psychiatry, Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia; Department of Psychiatry and Psychological Medicine, Faculty of Medicine in Rijeka, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
Elizabeta Dadić-Hero ; Clinic for Psychiatry, Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia; Department of Social Medicine and Epidemiology, Faculty of Medicine in Rijeka, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
Radmila Rebić ; Teaching Institute of Public Health of Primorsko-Goranska County, Krešimirova 52a, 51000 Rijeka, Croatia

* Corresponding author.

Abstract

It has been demonstrated that patients with bipolar
affective disorder (BAD) more often suffer
from inflammatory and autoimmune (AI) diseases,
and one of the most common AI conditions in
this patient population is Hashimoto’s thyroiditis.
This is a condition in which the immune system
“attacks” thyroid tissue, gradually leading to
its damage and dysfunction (most often reduced function), frequently with a consequent adverse
impact on mental health as well. In patients with
BAD, Hashimoto’s thyroiditis can destabilize the
mental state and also complicate the treatment
of BAD, especially because many mood stabilizers,
including lithium, are associated with thyroid
disorders. Therefore, in treating individuals with
comorbid BAD and Hashimoto’s thyroiditis, an
interdisciplinary approach is important, namely
cooperation between the psychiatrist and endocrinologist,
in order to achieve stability of both
mental and physical health. We present the case
of a younger female patient with comorbidity of
these conditions. After the diagnosis of thyroiditis,
the patient and her family insisted on discontinuing
lithium from the treatment regimen.
Almost a year after discontinuation of this drug,
anti‑TPO antibodies (specific for AI thyroid diseases)
remain markedly elevated (even twice as
high as values measured during lithium therapy),
while thyroid hormones are, for now, within normal
limits. In this case, the question arises as to
whether lithium influenced the development of
AI thyroiditis, or whether the decisive factor is
the pre‑existing hereditary burden for thyroid
disease.

Keywords

bipolar affective disorder (BAD); autoimmune diseases; Hashimoto’s thyroiditis; lithium; interdisciplinary approach

Hrčak ID:

353010

URI

https://hrcak.srce.hr/353010

Publication date:

15.6.2026.

Article data in other languages: croatian

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