ABSTRACT
This chapter educates contact physicians about affective, cognitive and behavioural symptoms that may be mistaken for psychiatric illness, but are, in fact, psychiatric manifestations of physical illness. It covers a range of disorders with neuropsychiatric presentations, including infectious diseases (including acquired immunodeficiency syndrome -related neuropsychiatric conditions), neurological disorders (including delirium and pain syndromes), endocrinological disorders (including thyroid diseases, diabetes and other endocrinopathies) and alcohol use. The best tool for diagnosis of mental disorders due to physical illness is an informed and attuned clinician with enough time to talk to the patient. Psychiatric symptoms in the anxiety and depressive disorders may be related to patients’ psychological responses to the physical effects of the disorder (including truncal obesity, hirsutism and infertility), in addition to the direct effects of neuroendocrine abnormalities. Practitioners in the general medical setting should be attentive to signs and symptoms that might indicate negative behaviours or poor self-care, which may be early signs of mental illness.
