Mental Handicap, Psychosis and Thyrotoxicosis: A Demonstration of the Usefulness of an Integrated Community and Hospital Service

A case is described of a moderately mentally handicapped woman referred to the local community mental handicap team with a diagnosis of bipolar affective disorder--manic phase. There was a possible association between her manic state and hyperthyroidism. Assessment and management were complicated by the development of neuroleptic-induced catatonia. The desirability of access to a local general psychiatric unit is discussed.