I often encounter patients diagnosed with schizophrenia who have been on antipsychotic medication for a long time with significant side effects and no reduction in symptoms, and whose parents are struggling with this but are at their wits’ end. But when you have to change the diagnosis to “obsessive-compulsive disorder” after a detailed consultation, the treatment plan changes dramatically as a result, and it often leads to a brighter future. Here is an example of a patient’s mother giving me an appointment in September 2015: “Female, 15 years old, said last June that a teacher at school was monitoring her, and did not mention it once during the 2 months of summer vacation, and then said at the end of September that the teacher was monitoring her, went to counseling in November, and in December I told the counselor that there was no such thing as monitoring, and she didn’t believe it was true, and in February and March of this year, she said that she had been monitored several times, and that she didn’t read much during this period, because she had a fight with her language teacher in the middle of May last year, which was a bit serious. She said again to spend that money why, there is no monitoring this thing to. July 12 this year to travel to New Malaysia and Thailand, to Singapore, because the guide said that Singapore’s laws are particularly harsh, she was very nervous and appeared to talk nonsense. I said after I came back that you may not be able to study if you talk nonsense again, she said that I do not say, the back did not say similar words, August 26 ordered take-away, after eating well she doubted that the take-away staff will not put the AIDS virus on the meat, she called the store and asked them if the take-away was clean, she seemed to eat a little different, people said very fresh, will not be bad, and then asked me to take her to the The hospital checked, and then said not to go out, asked me to take her to eat barbecue, September 2, because my shoes broke, I walked barefoot, she said again in case there is AIDS blood on the road, I will of AIDS. I explained to her that there are three ways to spread AIDS, and she believed it, but she didn’t mention it. Yesterday, when I went to study, she said she thought of taking drugs, and on the 2nd, she urinated and had urine in her pussy. Teacher, a she is not convinced of delusional content, you see, eat medicine for a month and a half, no effect a start to eat a piece of Alipay thwart 12 days after eating 3 tablets, eat 3 tablets after delusional content more.” ” Professor Li, I would like to consult again, please study the case again. There is also August 5 a trip to Hangzhou, in the moving train, she said eat chewing gum thing, I said eat chewing gum you said yesterday remembered the drug use on TV, she reacted very very strongly, said people will misunderstand that he was on drugs, a conductor to see us, she said the conductor will catch us, said I harmed her, 30 minutes has been pestered no way, to the she also did not get off, said the police will catch us, and then the people in the evening said that She just got off, to the subway, see the police, but also ran to ask the police, in the train said nonsense talk there is no matter, the police said what said, I said the drug thing, the police asked a few questions, told us to go, she just do not make trouble, there is also September 2, to the hospital for follow-up, to draw blood, she repeatedly asked the nurse will not be infected with AIDS, the needle is not disposable, but also asked the front desk. “ No wonder several doctors in Shanghai, Zhejiang and Suzhou who saw her implemented antipsychotic medication with a diagnosis of schizophrenia, because from the clinical manifestations described by the parents above, the following symptoms seem to be present: a sense of being watched (passive experience); confused speech (thought association disorder); delusions of victimization (poisoning by the delivery man); delusions of relationship (the train conductor thought he was going to arrest her after taking a look), etc. If I had not seen the patient, the diagnosis of “schizophrenia” would have been the first thing that would have come to mind if I had read the description alone. However, it was precisely the last sentence of the description (repeatedly asking the nurse if she had AIDS) that made me realize that this might be a patient with OCD. Some patients with OCD have symptoms of “obsessive suspicion” and need to use “obsessive questioning” to counteract their anxiety. So I took a detailed medical history, focusing on the patient’s self-awareness, pre-morbid personality, and the presence of compulsions and counter-compulsions, and then made a decisive diagnosis of OCD, telling her that she needed to be treated with a combination of medication and psychotherapy. The patient agreed, but her mother did not agree to the medication because of her mother’s concerns about the side effects of the medication mentioned earlier. After about a month or two, the mother called to say that the child was getting worse, so she agreed to my treatment plan and came back for a second visit. After this visit, I prescribed an appropriate dose of medication after the psychotherapy was completed, and a week later, her mother reported that her child was significantly better and thanked me profusely for that. In my opinion, there are two main reasons for these doctors’ misdiagnosis: one is the doctors’ lack of clinical experience (even famous psychiatrists often fall down on this one issue if they do not have long-term experience in neurological research); the other is the lack of careful examination. The more famous the hospital and the doctor, the more patients they have, and if they see a patient in a few minutes or ten minutes, it is inevitable that they will make mistakes. As mentioned above, I hope to draw the attention of psychiatrists in general, and more importantly, the attention of patients and their families.