“It’s a Psychiatric Patient”: Misdiagnosing of Somatic Symptoms in Patients with Mental Disorders Due to Stigma and Inadequate Diagnostic Treatment

Abstract

Aim: People with mental illness have more somatic comorbidities and are frequently mistreated. Misdiagnosis occurs for a variety of reasons, including stigma, poor communication, lack of knowledge of psychiatric pathology, and a tendency to attribute physical symptoms to a mental disorder. Case report: The factors listed above, as well as the unique circumstances of the COVID-19 pandemic led to the misdiagnosis in the case discussed in this paper. The patient was a middle-aged man diagnosed with an ICD-10 diagnosis of a chronic mental disorder in the F2 category and multiple somatic comorbidities in whom amiodarone-induced thyrotoxicosis was undiagnosed and somatic symptoms were attributed to antipsychotic-induced parkinsonism. The mechanism of amiodarone-induced thyrotoxicosis and antipsychotic-induced extrapyramidal symptoms will be described, together with the factors that caused our patient to be misdiagnosed. Conclusion: Psychiatric patients are often specific in their communication and behaviour, therefore interaction must be adapted, with a focus on destigmatizing and educating health workers.