title: Occam's razor cuts out the mind-body dichotomy.
abstract: Psychiatric symptoms are among the most common manifestations of endocrine disorders. We present a case of Schmidt's syndrome, or polyglandular type II failure. Due to a florid psychiatric presentation, the initial endocrine diagnosis was missed, and a diagnosis of a nonorganic psychotic illness was made. This impacted on the treatment and appropriate placement of the patient. This case is presented to illustrate the importance of the organic work-up and follow-up on abnormal laboratory results in patients with dementia. In the elderly, a new onset of psychosis is usually associated with an organic cause. Furthermore, the presence of either a fixed or intermittent change in cognitive function suggests a strong likelihood of organicity. These features were present, but not noted, leading to management problems that are described here to illustrate the need for careful clinical scrutiny.
authors.affiliation: Delaware Psychiatric Center, New Castle, Delaware, USA.
authors.forename: Ramnik
authors.initials: R
authors.lastname: Singh
authors.forename: Carol L
authors.initials: CL
authors.lastname: Kuprevich
authors.forename: Ronald
authors.initials: R
authors.lastname: Rosenbaum
authors.forename: Ranga N
authors.initials: RN
authors.lastname: Ram
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008487:Medical History Taking; D016884:Polyendocrinopathies, Autoimmune / Q000175:diagnosis* / Q000523:psychology; D011618:Psychotic Disorders / Q000175:diagnosis*