Not all episodes of disturbed or altered behavior can be attributed to purely psychiatric conditions. Many medical problems can present with predominantly behavioral symptoms. Dr. Paul Linde, Clinical Professor of Psychiatry at UCSF, explains that to discover the root cause of these so-called "medical mimics," one must start with an "index of suspicion" and continue the investigation with the clinician's basic tools of history, mental status description, physical examination, and diagnostic testing to uncover the potential medical causes of psychiatric symptoms. Putting together the multiple pieces of a clinical puzzle, accomplished in part by creating and considering a differential list of possibilities, is one of the most satisfying tasks for the psychiatric sleuth. (#25803)