Psychosis involves a break from reality, marked by hallucinations, delusions, disorganized thinking, or catatonia. However, many non-psychiatric conditions mimic these symptoms, leading to misdiagnosis. Accurate differentiation requires thorough medical evaluation.

Neurological disorders often imitate psychosis. Delirium, from infections, electrolyte imbalances, or medications, causes fluctuating confusion, hallucinations, and paranoia unlike the stable delusions in schizophrenia. Temporal lobe epilepsy can trigger auditory hallucinations or déjà vu, resembling psychotic episodes. Brain tumors, strokes, or traumatic brain injuries may produce visual hallucinations or bizarre beliefs due to organic damage.

Substance-related issues are common culprits. Intoxication with stimulants (e.g., amp cocaine, methamphetamine) induces paranoia and hallucinations; withdrawal from alcohol or benzodiazepines causes delirium tremens with vivid hallucinations. Hallucinogens like LSD provoke transient psychosis-like states. Even prescription drugs, such as steroids or anticholinergics, can spark delusions.

Medical illnesses mimic symptoms systemically. Thyroid storms (hyperthyroidism) lead to agitation and hallucinations; vitamin B12 deficiency causes paranoia; autoimmune encephalitis (e.g., anti-NMDA receptor) presents with rapid-onset psychosis, often with seizures. Infections like encephalitis or syphilis affect brain function, producing psychotic features.

Sleep and sensory deprivation trigger pseudo-psychosis. Extreme sleep deprivation causes perceptual distortions and paranoia. Sensory deprivation experiments historically induced hallucinations.

Cultural and psychological factors add complexity. Intense religious experiences or grief reactions may involve visions misinterpreted as psychosis. Bipolar mania features grandiosity akin to delusions.

Misdiagnosis risks inappropriate antipsychotic use, delaying treatment for reversible causes. Always rule out organic factors via labs, imaging, EEG, or toxicology before psychiatric labeling. Consult professionals for persistent symptoms.