Sharing the importance of a differential diagnosis

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I came across an article from the Washington Post about a misdiagnosis of a woman experiencing catatonia for 20 years, but actually had lupus, which was causing the psychosis.

For people who experience psychosis, they are suppose to receive a differential diagnosis for all possible known medical causes for psychosis first, which includes autoimmune diseases. It’s best practice to rule out all the known possible medical causes first before considering a psychiatric diagnosis and treatment. This apparently wasn’t done for her.

Furthermore, it’s recommended by the APA for folks who end up getting diagnosed with schizophrenia through the process of elimination that they get regular physical exams, which may have caught this for her in the blood work.

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.177901

The Washington Post wrote a very misleading OR poor researched article, seeming to imply this is the first time lupus was discovered for psychosis when it’s been long documented as a potential cause and should be considered in a differential diagnosis medical workup in the beginning.

The reporting is very upsetting for this woman misdiagnosed and another woman mentioned in the article who has been misdiagnosed for 10 years. And it’s upsetting for all the other potential people who might not be informed about differential diagnoses.

Bringing up the importance of differential diagnosis to the attention of others here because it’s not often brought up or discussed and often neglected in medical practice to do differential diagnoses even though they are best practices, because doctors just don’t do their due diligence a lot of the time and assume symptoms are psychiatric.

So I’m just passing along the importance of differential diagnosis if you didn’t know.

Original article posted with helpful links:
https://www.reddit.com/r/EverythingScience/comments/1440piu/a_catatonic_woman_awakened_after_20_years_her/?utm_source=share&utm_medium=android_app&utm_name=androidcss&utm_term=1&utm_content=share_button

There was a woman who commented about PANDAS that’s actually a relatively new discovery and very hard to diagnosis, but also good to know about as it’s new.

I hope folks find this information interesting and helpful for them and their relative’s health.

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Information on differential diagnosis for psychosis:

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Thanks for sharing Kirs. My late sister experienced catatonia early in her disease course which, although it is a symptom of SZ, could also be explained by other conditions. I remember when I was probably about 19 and seeing a therapist, I talked to her about how my sister told me that she would just lay on the bed for many hours disconnected from her brain. The therapist warned me that could have been something to look into, perhaps epilepsy or something else. I never looked into it. How could I have done so as a 19 year old? But looking back, it was an important clue that happened early that, if caught, could have changed the course of disease for my sister. I hope there are more rights for family members to be able to get help for their loved ones. We are too disempowered to help them in so many cases.

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Thanks for posting @bex . It is true that the law sometimes prevents family members from helping their loved ones with medical decisions. I learned that the hard way too when my adult daughter got ill. It is important to talk about this problem with loved ones and to get legal paperwork in order when everyone is healthy. Those are hard conversations and still my none of my adult children or my husband have done their paperwork although I got the full package from an Estate Planning lawyer.

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