[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-433433-105":59,"doc-detail-433433-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","diagnostic-pitfalls-in-psychiatry-misdiagnosed-psychosis-in-a-patient-with-intellectual-disability-a-case-report","Diagnostic Pitfalls in psychiatry - misdiagnosed psychosis in a patient with intellectual disability: a case report","","Misdiagnosis presents a substantial barrier in psychiatry, frequently exposing patients to inappropriate treatment risks. This case report describes a 35-year-old male with longstanding developmental delays who was repeatedly diagnosed with psychosis and treated with antipsychotics, later developing catatonia. Reassessment using developmental history and neuropsychological evaluation confirmed intellectual disability rather than primary psychosis. The revised diagnosis enabled discontinuation of antipsychotics and a shift toward psychosocial and behavioral support, with markedly better outcomes. Comprehensive developmental histories and periodic diagnostic review are essential to prevent harmful errors and optimize care.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/diagnostic-pitfalls-in-psychiatry-misdiagnosed-psychosis-in-a-patient-with-intellectual-disability-a-case-report/433433/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/diagnostic-pitfalls-in-psychiatry-misdiagnosed-psychosis-in-a-patient-with-intellectual-disability-a-case-report/433433.png","ImageObject",300,407,{"name":92,"@type":93},"dawugda","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why was the patient initially misdiagnosed with psychosis?","Question",{"text":112,"@type":113},"The patient had long-standing developmental delays whose developmental context was overlooked. Observable behavioral disturbances were repeatedly attributed to psychosis.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What led to the correct diagnosis?",{"text":117,"@type":113},"A thorough re-evaluation incorporating developmental history and neuropsychological assessment confirmed intellectual disability rather than primary psychosis.",{"name":119,"@type":110,"acceptedAnswer":120},"How did treatment change after the revised diagnosis?",{"text":121,"@type":113},"Antipsychotics were discontinued, a lorazepam challenge partly alleviated catatonia, and care shifted to supportive interventions, family psychoeducation, and behavioral strategies.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},433433,1791022372,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39,"preview_page_count":4},3985747870947,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Case Report  \nDiagnostic Pitfalls in psychiatry: misdiagnosed psychosis in a patient with intellectual disability: a case report  \nPukar Gupta, MBBSa ,*, Kamal Hamal, MBBSb , Roshni Thapa, MBBSa , Pradeep Adhikari, MBBSa , Rachana Thapa, MBBSa , Abhisekh Kharel, MDb , Anuva Khanal, MBBSb  \nIntroduction and importance: Misdiagnosis is a substantial obstacle in psychiatry, often exposing patients to unwarranted risks. Case presentation: We present a 35-year-old male with longstanding developmental delays who was repeatedly diagnosed with psychosis and treated with antipsychotics. He developed catatonia during his course of treatment. A thorough re-evaluation, incorporating developmental history and neuropsychological assessment, confirmed intellectual disability rather than primary psychosis.  \nClinical discussion: This example illustrates how diagnostic overshadowing and neglecting developmental history can result in treatment errors, such as catatonia due to improper antipsychotic medication. The results were much better after the right diagnosis and a move to psychosocial and behavioral therapy.  \nConclusion: A comprehensive developmental history and periodic diagnostic reassessment are essential in psychiatry to prevent harmful misdiagnosis and optimize patient care.  \nKeywords: catatonia, intellectual disability, misdiagnosis, psychiatry, psychosis  \nIntroduction  \nIntellectual disability (ID) is defined by limitations in intellectual functioning and adaptive behavior with onset during the developmental period [1] . Behavioral disturbances are common in these patients, and misinterpretation often leads to misdiagnosis of psychotic or mood disorders [2,3] . Misdiagnosis not only exposes patients to unnecessary medications but also risks complications such as catatonia[4] .  \nDiagnostic errors in psychiatry often arise from over-reliance on observable behaviors without sufficient developmental context, a phenomenon well-documented in recent literature[5,6] . In individuals with ID, this leads to “diagnostic overshadowing,”where psychiatric symptoms are attributed incorrectly to psychosis rather than to cognitive limitations or environmental stressors. This case describes a patient with ID misdiagnosed as psychosis and managed with antipsychotics, later complicated by catatonia. Timely recognition of ID corrected the diagnostic  \naNational Health Action Force Nepal, Kathmandu, Nepal and bDepartment of Psychiatry, Patan Academy of Health Sciences, Patan Hospital  \nSponsorships or competing interests that may be relevant to content are disclosed at the end of this article.  \n*Corresponding author. Address: National Health Action Force Nepal, Kathmandu 44600, Nepal. Tel.: +[977-9808872930. E-mail: drppukar007@gmail.com](977-9808872930. E-mail: drppukar007@gmail.com)[ ](977-9808872930. E-mail: drppukar007@gmail.com)(P. Gupta).  \nCopyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.  \nAnnals of Medicine & Surgery (2026) 88:844–846  \nReceived 1 September 2025; Accepted 11 November 2025  \nPublished online 24 November 2025  \n[http://dx.doi.org/10.1097/MS9.0000000000004378](http://dx.doi.org/10.1097/MS9.0000000000004378)  \nHIGHLIGHTS  \n● A patient with long-standing developmental deficits was repeatedly misdiagnosed as psychosis, resulting in catatonia due to antipsychotic exposure.  \n● A comprehensive reevaluation verified the diagnosis of intellectual disability, which led to a change in care to include psychological and behavioral support.  \n● The case underscores the imperative for a thorough developmental history and ongoing diagnostic reevaluation to prevent adverse mismanagement in psychiatry.  \ntrajectory a","cbCaido98NuFjusN","https://ap.wps.com/l/cbCaido98NuFjusN","pdf",219824,"English","# Introduction and importance\n# Case presentation\n# Clinical discussion\n# Conclusion\n# Highlights\n## Patient information\n## Clinical findings\n## Diagnostic assessment\n## Therapeutic intervention","[{\"question\":\"Why was the patient initially misdiagnosed with psychosis?\",\"answer\":\"The patient had long-standing developmental delays whose developmental context was overlooked. Observable behavioral disturbances were repeatedly attributed to psychosis.\"},{\"question\":\"What led to the correct diagnosis?\",\"answer\":\"A thorough re-evaluation incorporating developmental history and neuropsychological assessment confirmed intellectual disability rather than primary psychosis.\"},{\"question\":\"How did treatment change after the revised diagnosis?\",\"answer\":\"Antipsychotics were discontinued, a lorazepam challenge partly alleviated catatonia, and care shifted to supportive interventions, family psychoeducation, and behavioral strategies.\"}]","Diagnostic Pitfalls in psychiatry - misdiagnosed psychosis in a patient with intellectual disability: a case report | PDF",1790664091]