Psychotic disorder due to another medical condition

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Target exams

Red flags

• First psychosis after age 40–50, or any age with fever, seizure, meningism, focal neurology, or rapid cognitive decline — intensify organic work-up before locking a primary psychosis label
• Fluctuating attention with medical illness — diagnose and treat delirium; do not code as psychotic disorder due to another medical condition if features occur exclusively during delirium
• Subacute psychosis plus dyskinesias, speech reduction, autonomic instability, or catatonia — autoimmune encephalitis red flags; escalate MRI/EEG/CSF and antibody pathway (see AE topic)
• Young patient with psychosis plus abnormal LFTs, tremor, or movement disorder — consider Wilson disease before high-potency typical antipsychotics
• New high-dose corticosteroids with temporal psychosis — treat as medication-driven until proven otherwise; do not miss concurrent medical drivers
• Immunocompromise, HIV risk, or possible neurosyphilis — serology is not optional trivia
• Suspected raised intracranial pressure — image before LP