Skip to main content

Medical and Other Psychiatric Conditions Potentially Misdiagnosed as Schizophrenia

  • Chapter
  • First Online:
Schizophrenia Is a Misdiagnosis

Abstract

Although psychotic mood disorders likely account for a large majority of misdiagnoses of schizophrenia, many medical disorders, medications, drugs, and some other psychiatric disorders can present with psychotic features that can also lead to misdiagnoses of schizophrenia or a mood disorder. Hall et al. (1978) reported an incidence of medical disorders in 9.1% of 658 consecutive psychiatric outpatients that they felt caused the patients’ psychiatric symptoms. Such patients were most commonly misdiagnosed with schizophrenia and depression. A similarly designed study found 5.6% of first-episode patients diagnosed with schizophrenia had an unrecognized medical disorder that explained psychotic symptoms (Johnstone et al. 1987).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Adachi, N., Ito, M., Kanemoto, K., et al. (2007). Duration of postictal psychotic episodes. Epilepsia, 48, 1531–1537.

    Article  PubMed  Google Scholar 

  • Arzy, S., Seeck, M., Ortigue, S., Spinelli, L., & Blanke, O. (2006). Induction of an illusory shadow person. Nature, 443, 287.

    Article  PubMed  CAS  Google Scholar 

  • Bentall, R. P. (1990). The illusion of reality: A review and integration of psychological research on hallucinations. Psychological Bulletin, 107, 82–95.

    Article  PubMed  CAS  Google Scholar 

  • Bentall, R. (2004, March 20–23). Roll over Kraepelin, Mental Health Today.

    Google Scholar 

  • Bentall, R. (2006). Madness explained: why we must reject the Kraepelinian paradigm and replace it with a ‘complaint-oriented’ approach to understanding mental illness. Medical Hypotheses, 66, 220–233.

    Article  PubMed  Google Scholar 

  • Bentall, R. P., & Fernyhough, C. (2008). Social predictors of psychotic experiences: specificity and psychological mechanisms. Schizophrenia Bulletin, 34, 1012–1020.

    Article  PubMed  Google Scholar 

  • Bentall, R. P., Jackson, H. F., & Pilgrim, D. (1988). Abandoning the concept of ‘schizophrenia:’ some implications of validity arguments for psychological research into psychotic phenomena. The British Journal of Clinical Psychology, 27, 303–324.

    Article  PubMed  Google Scholar 

  • Bottas, A., Cooke, R. G., & Richter, M. A. (2005). Comorbidity and pathophysiology of obsessive-compulsive disorder in schizophrenia: Is there evidence for a schizo-obsessive subtype of schizophrenia? Journal of Psychiatry & Neuroscience, 30, 187–193.

    Google Scholar 

  • Carlson, G. A., & Goodwin, F. K. (1973). The stages of mania. A longitudinal analysis of the manic episode. Archives of General Psychiatry, 28, 221–228. (Chaps. 1, 8).

    Article  PubMed  CAS  Google Scholar 

  • Caton, C. L., Drake, R. E., Hasin, D. S., et al. (2005). Differences between early-phase primary psychotic disorders with concurrent substance use and substance-induced psychoses. Archives of General Psychiatry, 62, 135–145. (Published correction appears in Archives of General Psychiatry. 2005;62:493).

    Article  Google Scholar 

  • Chouinard, G., & Jones, B. (1980). Neuroleptic-induced supersensitivity psychosis: clinical and pharmacologic characteristics. The American Journal of Psychiatry, 137, 16–20. (Chap. 14).

    PubMed  CAS  Google Scholar 

  • Devinsky, O. (2008). Postictal psychosis: Common, dangerous, and treatable. Epilepsy Curr, 8, 31–34.

    Article  PubMed  Google Scholar 

  • Doran, A. R., Breier, A., & Roy, A. (1986). Differential diagnosis and diagnostic systems in Schizophrenia. Psychiatric Clinics of North America, 9, 17–33. (Chaps 2, 8).

    PubMed  CAS  Google Scholar 

  • Douglas, A. B. (2003). Narcolepsy: Differential diagnosis or etiology in some cases of bipolar disorder and schizophrenia? CNS Spectrums, 8, 120–126.

    Google Scholar 

  • Downs, J. M., Akiskal, H. G., & Rosenthal, T. L. (1993) Presented at the Annual Meeting of the American Psychiatric Association. Abstract 146.

    Google Scholar 

  • Freudenreich, O. (2010). Differential diagnosis of psychotic symptoms: Medical “mimics. Psychiatric Times, XXVII, 56–61.

    Google Scholar 

  • Freudenreich, O., Holt, D. J., Cather, C., & Goff, D. C. (2007). The evaluation and management of patients with first-episode schizophrenia: A selective, clinical review of diagnosis, treatment and prognosis. Harvard Review of Psychiatry, 15, 189–211.

    Article  PubMed  Google Scholar 

  • Goodwin, F. K. (1989). The biology of recurrence: New directions for the pharmacologic bridge. The Journal of Clinical Psychiatry, 50, 40–44. (Chaps. 8, 9, 10, 18).

    PubMed  Google Scholar 

  • Hall, R. C. W., Popkin, M. K., DeVaul, M. K., et al. (1978). Physical illness presenting as psychiatric disease. Archives of General Psychiatry, 35, 1315–1320.

    Article  PubMed  CAS  Google Scholar 

  • Honig, A., Romme, M. A. J., Ensink, B. J., Escher, S. D., Pennings, M. H., & Devries, M. W. (1998). Auditory hallucinations: A comparison between patients and non-patients. The Journal of Nervous and Mental Disease, 186, 646–651.

    Article  PubMed  CAS  Google Scholar 

  • Hwang, M. Y., Yum, S. Y., Kwon, J. S., & Opler, L. A. (2005). Management of schizophrenia with obsessive-disorder. Psychiatric Annals, 35, 36–43.

    Google Scholar 

  • Johnstone, E. C., Macmillan, J. F., & Crow, T. J. (1987). The occurrence of organic disease of possible or probable aetiological significance in a population of 268 cases of first episode schizophrenia. Psychological Medicine, 17, 371–379. (Chap. 14).

    Article  PubMed  CAS  Google Scholar 

  • Kendell, R. E., & Gourlay, J. (1970a). The clinical distinction between psychotic and neurotic depressions. The British Journal of Psychiatry, 117, 257–260. (Chap. 8).

    PubMed  CAS  Google Scholar 

  • Kendell, R. E., & Gourlay, J. (1970b). The clinical distinction between the affective psychoses and schizophrenia. The British Journal of Psychiatry, 117, 261–266. (Chap. 8).

    PubMed  CAS  Google Scholar 

  • Kendler, K. S., Gallagher, T. J., Ableson, J. M., & Kessler, R. C. (1996). Lifetime prevalence, demographic risk factors and diagnostic validity of non-affective psychosis as assessed in a US community sample. Archives of General Psychiatry, 53, 1022–1031. (Chap. 14).

    Article  PubMed  CAS  Google Scholar 

  • Lake, C. R. (2008c). How academic psychiatry can better prepare our students for their future patients: Part I: The failure to recognize depression and risk for suicide in primary care; problem identification, responsibility and solutions. Behavioral Medicine, 34, 95–100.

    Article  PubMed  Google Scholar 

  • Lake, C. R. (2008d). How academic psychiatry can better prepare our students for their future patients: Part II: A course in ultra-brief initial diagnostic screening suitable for future primary care physicians. Behavioral Medicine, 34, 101–116.

    Article  PubMed  Google Scholar 

  • Lenggenhager, B., Tadi, T., Mdtzinger, T., & Blanke, O. (2007). Video ergo sum: Manipulating bodily self-consciousness. Science, 317, 1096–1099.

    Article  PubMed  CAS  Google Scholar 

  • Lu, M. L., Pan, J. J., Tang, H. W., Su, K. P., & Shen, W. W. (2002). Metoclopramide-induced supersensitivity psychosis. The Annals of Pharmacotherapy, 36, 1387–1390. (Chap. 12).

    Article  PubMed  Google Scholar 

  • Mahgoub, N., & Serby, M. (2007). Charles Bonnet syndrome: Long-term outcome of treatment. Psychiatric Annals, 37, 579–580.

    Google Scholar 

  • Martin, M. J. (1983). A brief review of organic diseases masquerading as functional illness. Hospital & Community Psychiatry, 34, 328–332. (Chap. 10).

    CAS  Google Scholar 

  • Moore, R., Blackwood, N., Corcoran, R., Rowse, G., Kinderman, P., Bentall, R., & Howard, R. (2006). Misunderstanding in the intentions of others: an exploratory study of the cognitive etiology of persecutory delusions in very late-onset schizophrenia-like psychosis. The American Journal of Geriatric Psychiatry, 14, 410–418.

    Article  PubMed  Google Scholar 

  • Moynihan, R., Heath, I., & Henry, D. (2002). Selling sickness: The pharmaceutical industry and disease mongering. British Medical Journal, 324, 886–891.

    Article  PubMed  Google Scholar 

  • Perea, E., Robbins, B. V., & Hutto, B. (2006). Psychosis related to ropinirole. The American Journal of Psychiatry, 163, 547–548.

    Article  PubMed  Google Scholar 

  • Pini, S., Cassano, G. B., Dell’Osso, L., & Amador, X. F. (2001). Insight into illness in schizophrenia, schizoaffective disorder, and mood disorders with psychotic features. The American Journal of Psychiatry, 158, 122–125. (Chaps. 8, 9).

    Article  PubMed  CAS  Google Scholar 

  • Pope, H. G. (1983). Distinguishing bipolar disorder from schizophrenia in clinical practice: Guidelines and case reports. Hospital & Community Psychiatry, 34, 322–328. (Chaps. 1, 8).

    Google Scholar 

  • Pope, H. G., & Katz, D. L. (1988). Affective and psychotic symptoms associated with anabolic steroid use. The American Journal of Psychiatry, 145, 487–490.

    PubMed  Google Scholar 

  • Pope, H. G., & Lipinski, J. F. (1978). Diagnosis in schizophrenia and manic-depressive illness, a reassessment of the specificity of “schizophrenic” symptoms in the light of current research. Archives of General Psychiatry, 35, 811–828.

    Article  PubMed  Google Scholar 

  • Post, R. M. (1992). Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. The American Journal of Psychiatry, 149, 999–1010. (Chap. 8).

    PubMed  CAS  Google Scholar 

  • Poyurovsky, M., Fuchs, C., & Weizman, A. (1999). Obsessive-compulsive disorder in patients with first-episode schizophrenia. The American Journal of Psychiatry, 156, 1998–2000.

    PubMed  CAS  Google Scholar 

  • Rottnek, M., Riggio, S., Byne, W., Sano, M., Margolis, R. L., & Walker, R. H. (2008). Schizophrenia in a patient with spinocerebellar ataxia 2: Coincidence of two disorders or a neurodegenerative disease presenting with psychosis? The American Journal of Psychiatry, 165, 964–967.

    Article  PubMed  Google Scholar 

  • Steiner, W., Laporta, M., & Chouinard, G. (1990). Neuroleptic-induced supersensitivity psychosis in patients with bipolar affective disorder. Acta Psychiatrica Scandinavica, 81, 437–440. (Chap. 12).

    Article  PubMed  CAS  Google Scholar 

  • Swartz, C. M. (1995). Tardive psychopathology. Neuropsychobiology, 32, 115–119. (Chap. 12).

    Article  PubMed  CAS  Google Scholar 

  • Swartz, C. M. (2001). Misdiagnosis of schizophrenia for a patient with epilepsy. Psychiatry Services, 52, 109–110. (Chap. 12).

    Article  CAS  Google Scholar 

  • Swartz, C. M. (2004, October). Antipsychotic psychosis. Psychiatric Times, pp. 17–20. (Chap. 12).

    Google Scholar 

  • Tibbo, P., Kroetsch, M., Chue, P., & Warneke, L. (2000). Obsessive-compulsive disorder in schizophrenia. Journal of Psychiatric Research, 34, 139–146.

    Article  PubMed  CAS  Google Scholar 

  • van Os, J., Hanssen, M., Bijl, R. V., & Ravelli, A. (2000). Strauss (1969) revisited: A psychosis continuum in the general population? Schizophrenia Research, 45, 11–20.

    Article  PubMed  Google Scholar 

  • Verdoux, H., & van Os, J. (2002). Psychotic symptoms in non-clinical populations and the continuum of psychosis. Schizophrenia Research, 54, 59–65.

    Article  PubMed  Google Scholar 

  • Viguera, A. C., Baldessarini, R. J., Hegarty, J. D., van Kammen, D. P., & Tohen, M. (1997). Clinical risk following abrupt and gradual withdrawal of maintenance neuroleptic treatment. Archives of General Psychiatry, 54, 49–55. (Chap. 12).

    Article  PubMed  CAS  Google Scholar 

  • Weinberger, D. R., Bigelow, L., Klein, S. T., & Wyatt, R. J. (1981). Drug withdrawal in chronic schizophrenia patients: In search of neuroleptic induced supersensitivity psychosis. Journal of Clinical Psychopharmacology, 1, 120–123. (Chap. 12).

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Raymond Lake M.D., Ph.D. .

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Lake, C.R. (2012). Medical and Other Psychiatric Conditions Potentially Misdiagnosed as Schizophrenia. In: Schizophrenia Is a Misdiagnosis. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-1870-2_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-1870-2_14

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4614-1869-6

  • Online ISBN: 978-1-4614-1870-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics