Neurosyphilis (NSy) and Hashimoto’s thyroiditis may present with neuropsychiatric symptoms so they should always be kept in mind in the differential diagnosis of psychiatric patients. Psychiatric symptoms with presence of these diseases cannot be realized. In this case, there is a possibility of the psychiatric illness to be related to NSy first. Also, yet another confounding factor to the characteristics of the clinical picture was the hypothyroidism detected which was related to autoimmune Hashimoto’s thyroiditis. As etiological or confounding factors, NSy and Hashimoto’s thyroiditis are treatable but they can be detected late in the course of illness. It may be stated that hypothyroidism was a comorbid condition which further worsened the clinical picture. Unsatisfactory clinical improvement in some cases may be attributed to the late detection and consequently the late intervention for both organic etiologies.