The College Student Who Suddenly Became Psychotic: When Psychiatry Isn’t the Diagnosis

previously healthy college student develops insomnia, paranoia, bizarre behavior, and hallucinations before her condition rapidly deteriorates. At first, the presentation looks like a first episode of psychosis. But subtle neurological changes point clinicians toward a very different possibility: anti-NMDA receptor encephalitis. This case demonstrates why psychiatric symptoms sometimes require investigators to look beyond psychiatry.