A diagnosis of schizophrenia may be missed or delayed because people with schizophrenia may fear the stigma of or be embarrassed by mental illness and not seek treatment. In addition, people with schizophrenia often are unaware that their hallucinations and delusions are not real. They may not recognize that they are having symptoms or that their behavior has become inappropriate, dysfunctional, or a threat to their health.
A diagnosis of schizophrenia can be missed because symptoms of schizophrenia can be similar to symptoms of other diseases and conditions. These include bipolar disorder, hypoglycemia, brain tumor, delusional disorder, obsessive-compulsive disorder, depression, post traumatic stress disorder (PTSD), personality disorder, and substance abuse, such as the use of LSD or methamphetamine....more about Schizophrenia »
Schizophrenia misdiagnosis: When is a strongly held belief a full "delusion" versus just a different point of view? Not everyone who has paranoid beliefs is necessarily suffering from schizophrenia. In addition, DSM-IV also has several other possible diagnoses for paranoid personality types such as schizotypal, schizoid or paranoid personality disorder.
Not all concern about others is true paranoia. For example, social phobia can be misdiagnosed as paranoia and/or schizophrenia because people are concerned about others watching them or judging them....more about Schizophrenia »
For a diagnosis of Schizophrenia, the following list of conditions have been mentioned in sources as possible alternative diagnoses to consider during the diagnostic process for Schizophrenia:
The other diseases for which Schizophrenia is listed as a possible alternative diagnosis in their lists include:
Causes of Schizophrenia may include these medical conditions:
Related medical mistakes may include:
Commonly undiagnosed conditions in related areas may include:
It is important to rule out other illnesses, as sometimes people suffer severe mental symptoms or even psychosis due to undetected underlying medical conditions. For this reason, a medical history should be taken and a physical examination and laboratory tests should be done to rule out other possible causes of the symptoms before concluding that a person has schizophrenia. (Source: excerpt from Schizophrenia: NIMH)
At times, it is difficult to tell one mental disorder from another. For instance, some people with symptoms of schizophrenia exhibit prolonged extremes of elated or depressed mood, and it is important to determine whether such a patient has schizophrenia or actually has a manic-depressive (or bipolar) disorder or major depressive disorder. Persons whose symptoms cannot be clearly categorized are sometimes diagnosed as having a “schizoaffective disorder.” (Source: excerpt from Schizophrenia: NIMH)
Since some people who abuse drugs may show symptoms similar to those of schizophrenia, people with schizophrenia may be mistaken for people "high on drugs.” While most researchers do not believe that substance abuse causes schizophrenia, people who have schizophrenia often abuse alcohol and/or drugs, and may have particularly bad reactions to certain drugs. (Source: excerpt from Schizophrenia: NIMH)
At times, normal individuals may feel, think, or act in ways that resemble schizophrenia. Normal people may sometimes be unable to “think straight.” They may become extremely anxious, for example, when speaking in front of groups and may feel confused, be unable to pull their thoughts together, and forget what they had intended to say. This is not schizophrenia. At the same time, people with schizophrenia do not always act abnormally. Indeed, some people with the illness can appear completely normal and be perfectly responsible, even while they experience hallucinations or delusions. An individual’s behavior may change over time, becoming bizarre if medication is stopped and returning closer to normal when receiving appropriate treatment. (Source: excerpt from Schizophrenia: NIMH)
Schizophrenia often has misdiagnosed hidden cause: The book "Preventing Misdiagnosis of Women" reports on a study citing that 83% of people with a diagnosis of schizophrenia actually had brain lesions (i.e. brain tumors) or temporal lobe seizures. See Preventing Misdiagnosis of Women (by Klonoff and Landrine); see also introduction to schizophrenia.
Underactive thryoid may be misdiagnosed as depression: Hypothyroidism, or underactive thyroid, is an endocrine gland disorder that is more common in women. It can mimic many diseases, including depression. The patient often has depressive type symptoms, and may also have other symptoms of hypothyroidism such as tingling fingers (peripheral neuropathy), hearing loss, headaches, cold insensitivity, and many other symptms. Common misdiagnoses of hypothyroidism include depression, dementia, schizophrenia, or bipolar disorder (esp. rapid-cycling bipolar disorder).
Adrenal gland disorder difficult to correctly diagnose: Addison's disease, a disorder of the adrenal glands, causes a variety of symptoms, and is often misdiagnosed in early stages. Common misdiagnoses include depression or schizophrenia.
Cushing's disease can be mistaken for depression: Cushing's disease (or similarly Cushing's syndrome) is a possible misdiagnosis for a person diagnosed with depression. It is an endocrine disorder with many depressive-like characteristics, but also some physical symptoms; see symptoms of Cushing's disease. Cushing's disease may also have schizophrenia-like symptoms such as paranoia and delusions, leading to a misdiagnosis of schizophrenia. Manic or euphoria type symptoms are also possible, with a misdiagnosis of bipolar disorder. See overviews of depression, bipolar disorder, schizophrenia, and Cushing's disease.
Manic-depressive (bipolar) disorder often misdiagnosed: Bipolar disorder, also called manic-depressive disorder, is often misdiagnosed before reaching a correct diagnosis. Some of the common misdiagnoses include depression and schizophrenia. See introduction to bipolar disorder.
Epilepsy misdiagnosed as schizophrenia: The book "Preventing Misdiagnosis of Women" reports on a case of a woman diagnosed with schizophrenia, but later diagnosed with a form of epilepsy called "temporal lobe epilepsy". A variety of sensory symptoms, such as the feeling of the floor rushing upwards, were misdiagnosed as "paranoia". See schizophrenia or epilepsy.
Simple hearing loss can be misdiagnosed: Elderly patients can be misdiagnosed owing to symptoms of paranoia, when the underlying cause is really simple hearing loss. Due to their inability to hear properly what people are saying, elderly patients can become more prone to paranoia, believing that people are "whispering" about them. Similarly, memory loss can also cause an increased prevalance of paranoia-like symptoms in the elderly.
Various mental health symptoms caused by rare epilepsy: Temporal lobe epilepsy is a less common form of epilepsy that does not have the typical physical seizures. Patients can suffer from symptoms such as depression, moodiness, anger, irritability, and misdiagnosis of this condition as depression is common. Some patients also suffer hallucinations and other similar symptoms, or even severe psychotic symptoms, making a misdiagnosis of schizophrenia possible. Mood changes and behavioral symptoms also make a misdiagnosis of bipolar disorder possible. See the overview of temporal lobe epilespy.
Rare seizure-less epilepsy misdiagnosed as various conditions: A complex partial seizure disorder, such as temporal lobe epilepsy can be misdiagnosed as various conditions. Some of the possible misdiagnoses include depression, bipolar disorder, schizophrenia, borderline personality disorder, multiple personality disorder, somatization disorder, hypochrondria, an anxiety disorder, sexuality disorders, hysteria, and fugue.
Lupus is often misdiagnosed as other conditions: Systemic lupus erythematosus (SLE), often simply called "lupus", is a difficult disease to diagnose and can manifest with numerous symptoms. Some of the possible misdiagnoses include depression, bipolar disorder, anorexia nervosa, chronic fatigue syndrome, fibromyalgia, schizophrenia (a less common manifestation of lupus with hallucinations and/or delusions), conversion disorder, somatization disorder, hysteria and other diagnoses. See the overview of lupus or symptoms of lupus.
Rare copper disease insidious and misdiagnosed: Wilson's disease (a form of copper overload) is a rare disorder that has a slow and insidious onset that can often fail to be diagnosed. Copper builds up in the liver and in the brain, usually in the late childhood, teens, or 20's. Brain changes can lead to a variety of neurological and psychological type symptoms, such as speech symptoms, language difficulty, behavioral symptoms, and various others. Possible misdiagnoses include depression, behavioral disorders, schizophrenia, mental retardation, learning difficulty, anxiety disorders, hysteria, and other psychological disorders. Physical symptoms related to liver damage, such as jaundice, often appear later, leading to the delayed diagnosis. See overview of Wilson's disease.
Undiagnosed stroke leads to misdiagnosed aphasia: BBC News UK reported on a man who had been institutionalized and treated for mental illness because he suffered from sudden inability to speak. This was initially misdiagnosed as a "nervous breakdown" and other mental conditions. He was later diagnosed as having had a stroke, and suffering from aphasia (inability to speak), a well-known complication of stroke (or other brain conditions).
Dementia may be a drug interaction: A common scenario in aged care is for a patient to show mental decline to dementia. Whereas this can, of course, occur due to various medical conditions, such as a stroke or Alzheimer's disease, it can also occur from a side effect or interaction between multiple drugs that the elderly patient may be taking. There are also various other possible causes of dementia.
Mild traumatic brain injury often remains undiagnosed: Although the symptoms of severe brain injury are hard to miss, it is less clear for milder injuries, or even those causing a mild concussion diagnosis. The condition goes by the name of "mild traumatic brain injury" (MTBI). MTBI symptoms can be mild, and can continue for days or weeks after the injury. See the symptoms of MTBI or misdiagnosis of MTBI.
ADHD under-diagnosed in adults: Although the over-diagnoses of ADHD in children is a well-known controversy, the reverse side related to adults. Some adults can remain undiagnosed, and indeed the condition has usually been overlooked throughout childhood. There are as many as 8 million adults with ADHD in the USA (about 1 in 25 adults in the USA). See misdiagnosis of ADHD or symptoms of ADHD.
MTBI misdiagnosed as balance problem: When a person has symptoms such as vertigo or dizziness, a diagnosis of brain injury may go overlooked. This is particularly true of mild traumatic brain injury (MTBI), for which the symptoms are typically mild. The symptoms has also relate to a relatively mild brain injury (e.g. fall), that could have occurred days or even weeks ago. Vestibular dysfunction, causing vertigo-like symptoms, is a common complication of mild brain injury. See causes of dizziness, causes of vertigo, or misdiagnosis of MTBI.
Bipolar disorder misdiagosed as various conditions by primary physicians: Bipolar disorder (manic-depressive disorder) often fails to be diagnosed correctly by primary care physicians. Many patients with bipolar seek help from their physician, rather than a psychiatrist or psychologist. See misdiagnosis of bipolar disorder.
Eating disorders under-diagnosed in men: The typical patient with an eating disorder is female. The result is that men with eating disorders often fail to be diagnosed or have a delayed diagnosis. See misdiagnosis of eating disorders or symptoms of eating disorders.
Depression undiagnosed in teenagers: Serious bouts of depression can be undiagnosed in teenagers. The "normal" moodiness of teenagers can cause severe medical depression to be overlooked. See misdiagnosis of depression or symptoms of depression.
Brain pressure condition often misdiagnosed as dementia: A condition that results from an excessive pressure of CSF within the brain is often misdiagnosed. It may be misdiagnosed as Parkinson's disease or dementia (such as Alzheimer's disease). The condition is called "Normal Pressure Hydrocephalus" (NPH) and is caused by having too much CSF, i.e. too much "fluid on the brain". One study suggested that 1 in 20 diagnoses of dementia or Parkinson's disease were actually NPH. See misdiagnosis of Alzheimer's disease or misdiagnosis of Parkinson's disease.
Post-concussive brain injury often misdiagnosed: A study found that soldiers who had suffered a concussive injury in battle often were misdiagnosed on their return. A variety of symptoms can occur in post-concussion syndrome and these were not being correctly attributed to their concussion injury. See introduction to concussion.
Children with migraine often misdiagnosed: A migraine often fails to be correctly diagnosed in pediatric patients. These patients are not the typical migraine sufferers, but migraines can also occur in children. See misdiagnosis of migraine or introduction to migraine.
Undiagnosed anxiety disorders related to depression: Patients with depression (see symptoms of depression) may also have undiagnosed anxiety disorders (see symptoms of anxiety disorders). Failure to diagnose these anxiety disorders may worsen the depression. See misdiagnosis of depression or misdiagnosis of anxiety disorders.
Rare types of medical disorders and diseases in related medical areas:
The following medical news items are relevant to misdiagnosis of Schizophrenia:
Schizophrenia is a condition that can possibly be deadly if misdiagnosed...more »
Read these general articles with an overview of misdiagnosis issues.
When checking for a misdiagnosis of Schizophrenia or confirming a diagnosis of Schizophrenia, it is useful to consider what other medical conditions might be possible misdiagnoses or other alternative conditions relevant to diagnosis. These alternate diagnoses of Schizophrenia may already have been considered by your doctor or may need to be considered as possible alternative diagnoses or candidates for misdiagnosis of Schizophrenia. For a general overview of misdiagnosis issues for all diseases, see Overview of Misdiagnosis.
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