One day last year, one of my counselor friends, Zhou Yan, made an appointment for me to see a rural patient, male, in his 20s. The patient had been studying abroad and returned home a few days later with a gradual psychotic episode of unknown origin, which was sometimes mild and sometimes severe, with confused speech and bizarre content. The mother accompanied the patient and did not know if there was any trigger; the patient was described as introverted; there was no family history of psychosis. Psychiatric examination: answers to questions, but not pertinent enough; scattered associations, some with more words, some with less; more sexual content involving family incest (but denied by his mother as a pathological belief of the patient), etc., rather bizarre; occasional uncoordinated movements (e.g., patting the thigh without the corresponding verbal context), etc. At that time, it looked like a youthful type of schizophrenia, and since the course of the disease had not reached one month, a transitional diagnosis was made: schizophrenia-like psychosis. She was treated with antipsychotic drugs. A week later, Zhou Yan told me that this patient did not have significant relief after returning, and his family brought him to the Great Spirit to see him, and he was cured once! Oh, it seems that I misdiagnosed the hysteria, and I am really sorry for Zhou Yan. Although this is a very faceless blunder, but I am still willing to present to everyone to learn from. Analysis of the reasons for the misdiagnosis: (1) “No” obvious causative factors. In fact, the companion was unable to provide one; (2) male. Male dysthymia episodes are rare, and I have treated only single-digit male dysthymia in the last 30 years of clinical practice; (3) onset in the 20s, with an introverted personality. This is the first onset of schizophrenia and the pre-morbid personality, not a performative personality; (4) the clinical presentation is very similar to the youthful type. In fact, the patient’s consciousness seemed hazy at the time, and a careful examination of his state of consciousness should have enabled him to make a correct judgment; (5) It was only a one-hour cross-sectional examination, but unfortunately there was no longitudinal observation. Because the patient and family were in a hurry to return home, there was no opportunity for further observation. This case of misdiagnosis reminds us that we must be careful in outpatient visits, be as open-minded as possible, and ask the patient to be re-examined to facilitate longitudinal observation. In this way, errors can be avoided.