Case Report

Exacerbation of Psychosis by Misinterpretation of Physical Symptoms

Authors: Roy R. Reeves, DO, PHD, Rafael A. Torres, MD


Impaired processing of perceptual information is often a prominent aspect of psychotic disorders. Physical symptoms such as pain or discomfort may be either incorrectly perceived or misinterpreted by psychotic patients. Presented here is a series of cases in which somatic symptoms occurred in psychotic patients and worsened their psychotic states but only later were recognized as physical problems. Psychotic patients may be unable to comprehend or describe their physical symptoms adequately. Physical disorders of psychotic patients may be overlooked if clinicians are not vigilant and thorough in assessing the patients’ complaints, especially if such complaints sound delusional or bizarre.

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1. Braff DL. Information processing and attention dysfunctions in schizophrenia. Schizophr Bull 1993; 19: 233–259.
2. Reeves RR, Mustain DW, Pendarvis JE. Valproate-induced tinnitus misinterpreted as psychotic symptoms. South Med J 2000; 93: 1030–1031.
3. Slaughter JR, Zanol K, Rezvani H, Flax J. Psychogenic parasitosis: A case series and literature review. Psychosomatics 1998; 39: 491–500.
4. Braff DL, Geyer MA. Sensorimotor gating and schizophrenia: Human and animal model studies. Arch Gen Psychiatry 1990; 47: 181–188.
5. Light GA, Braff DL. Human and animal studies of schizophrenia-related gating deficits. Curr Psychiatry Rep 1999; 1: 31–40.
6. Ford JM, Roth WT, Menon V, Pfefferbaum A. Failures of automatic and strategic processing in schizophrenia: Comparisons of event-related brain potential and startle blink modification. Schizophr Res 1999; 37: 149–163.
7. Parwani A, Duncan EJ, Bartlett E, Madonick SH, Efferen TR, Rajan R, et al. Impaired prepulse inhibition of acoustic startle in schizophrenia. Biol Psychiatry 2000; 47: 662–669.
8. Perry W, Geyer MA, Braff DL. Sensorimotor gating and thought disturbance measured in close temporal proximity in schizophrenic patients. Arch Gen Psychiatry 1999; 56: 277–281.
9. Braff DL, Swerdlow NR, Geyer MA. Symptom correlates of prepulse inhibition deficits in male schizophrenic patients. Am J Psychiatry 1999; 156: 596–602.

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