Friday Factoids: Differential Diagnosis of Psychosis

A number of different medical conditions can cause psychotic symptoms in individuals.  Some, like the delirium after surgery, epilepsy and urinary tract infections, are well known, but some are less well-known. This is a more comprehensive list of medical conditions that sometimes cause psychotic symptoms.  These conditions should be ruled out prior to a diagnosis of a psychiatric disorder. Information about age, and health history should be used to determine if these conditions are a likely reason for the emergence of psychotic symptoms:



  • Hyper- or hypothyroidism
  • Cushing’s Disease (Cushing’s Syndrome) (increased release of cortisol due to a tumor)
  • Insulinoma (tumor on the pancreas)
  • Adult-onset Tay-Sachs Disease and Neimann-Pick Type C disorders (genetic conditions)
  • Lupus (auto-immune disorder)
  • Hashimoto Encephalopathy
  • Diseases uncommon in the US, but prevalent in other places may cause psychosis
    1. Cerebral malaria
    2. Toxoplasmosis
  • HIV
  • Syphilis/neurosyphilis
  • Narcolepsy (excessive daytime sleepiness)


Freudenreich, O. (2010). Differential diagnosis of psychotic symptoms: medical mimics. Psychiatric Times27(12), 56-61.


Maria Stacy, MA
WKPIC Doctoral Intern



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