Altered mental status is a common chief complaint in the emergency department. The differential diagnosis is vast and the laboratory testing can vary depending on presenting symptoms and examination findings. It is important to remember that changes in mental status can be due to psychiatric causes such as primary psychotic disorders, psychotic episodes, and mood disorders. Initial assessment includes ruling out hypoglycemia and other medical causes. Misdiagnosis at onset is common due to variability of symptoms, overlapping symptoms between diagnoses and other confounding issues, such as substance use, behavioral disorders, and possible developmental delays. After ruling out a medical cause, the patient should be evaluated by a mental health professional to determine psychiatric diagnosis and to dictate further management. [Pediatr Ann. 2019;48(5):e201-e204.].
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