Differential Diagnosis for Hair Falling Out, Psychosis, and Perseveration

Single Most Likely Diagnosis

• Hypothyroidism: This condition can cause hair loss, and in severe cases, particularly if left untreated, it can lead to psychiatric symptoms including psychosis and cognitive impairments such as perseveration. The broad range of symptoms from physical to psychiatric makes it a strong candidate.

Other Likely Diagnoses

• Schizophrenia: While primarily a psychiatric disorder, schizophrenia can sometimes present with disorganized thinking and behavior that might be interpreted as perseveration. Hair loss could be secondary to poor self-care or medication side effects.
• Bipolar Disorder: During manic or mixed episodes, individuals might exhibit psychotic symptoms and disorganized thinking. Hair loss could be related to stress, medication, or poor self-care.
• Autoimmune Disorders (e.g., Lupus): Systemic lupus erythematosus (SLE) can cause a wide range of symptoms including hair loss, psychiatric symptoms like psychosis, and cognitive issues due to its autoimmune nature affecting multiple body systems.

Do Not Miss Diagnoses

• Hyperthyroidism: Though less likely to cause psychosis compared to hypothyroidism, in rare cases, hyperthyroidism can lead to severe psychiatric symptoms. Hair loss is a common symptom, and the condition requires prompt treatment to avoid serious complications.
• Neurosyphilis: A potentially life-threatening condition if not treated, neurosyphilis can cause a wide range of psychiatric and neurological symptoms, including psychosis and cognitive disturbances. Hair loss might not be a primary symptom but could occur in the context of overall health decline.
• Vitamin B12 Deficiency: This condition can lead to neurological and psychiatric symptoms, including psychosis and cognitive impairments. Hair loss can also occur due to the deficiency's impact on the body's overall health.

Rare Diagnoses

• Creutzfeldt-Jakob Disease: A rare, degenerative, fatal brain disorder that can cause a variety of neurological symptoms, including dementia, memory loss, and personality changes. While hair loss is not a primary symptom, the rapid progression of the disease could lead to a wide range of symptoms.
• Wilson's Disease: A genetic disorder that leads to copper accumulation in the body, particularly the brain and liver. It can cause psychiatric symptoms, including psychosis, and neurological symptoms. Hair loss might not be a primary symptom but could occur due to the disease's impact on overall health.