A Patient With Schizophrenia's Journey to an Autoimmune Encephalitis Diagnosis: Shedding Light on Common Clinical Biases.

Abstract

The interplay between psychiatric and neurological disorders often complicates diagnostic processes, leading to significant challenges in distinguishing between mental illnesses and neurological conditions. This complexity is further exacerbated by diagnostic overshadowing, a phenomenon where symptoms of one disorder may mask or alter the perception of the other. Through the lens of a nuanced case, we chronicle the journey of a 73-year-old male with longstanding schizophrenia whose later development of motor symptoms was initially attributed to side effects of his psychiatric medication. As his general condition tended to worsen over time, a more in-depth investigation revealed a more profound neurological underpinning, illustrating the perilous path of misdiagnosis that persisted for several months. We also interweave a brief review of analogous cases in the literature that underscore the impact of decision-making errors in medical practice, highlighting the necessity for critical thinking, continuous vigilance, and the implementation of strategies to mitigate diagnostic errors.