RESUMO
In practice, when seeing patients with psychiatric manifestations, non-psychiatrist clinicians may often face diagnostic dilemmas. Due to inadequate experience in psychiatry, they have a tendency to sometimes try to quickly send the patient for a psychiatric evaluation even before doing a complete medical history and physical examination. They may overlook the fact that psychiatric manifestations may either be due to a psychiatric problem or they may be due to a physical illness or there may be a physical and a psychiatric disorder co-existing. On the other hand. it is also important for the psychiatrists to remember that the underlying cause of psychiatric manifestations may not always be a psychiatric illness; so, if one is not careful, it may lead to serious errors of judgment and missed physical illness could be life threatening. The purpose of this article is to remind the doctors that it is bad practice to close the mind to the possibility of other co-morbid conditions and that psychiatric conditions may present with physical signs and physical conditions may manifest psychiatric symptoms that can both lead to management and diagnostic errors. Some diagnostic traps are as follows: a] Missing an organic or a psychiatric disorder when one is present as a co-morbid condition in a patient. b] Diagnosis of an organic condition when none is present. c] Seeking to make a single diagnosis of either organic or a functional disorder when both are present. Missing an organic disorder when one is present This happens most often due to failure to consider the possibility of an organic etiology for the psychiatric manifestations presented by a patient. This failure is more likely to occur when there are: 1. Cognitive changes that may be slight or at most unimpressive. 2. Typical functional symptoms like depressive or paranoid features dominating the cljnical picture