Co-occurrence of Gilbert's syndrome and psychosis

Idiopathic unconjugated hyperbilirubinaemia (Gilbert's syndrome) is a common benign disorder that, when seen in association with psychiatric illnesses, often leads to the inappropriate withholding of psychotropic medication. We describe three cases with Gilbert's syndrome and psychosis in which diagnosis of Gilbert's syndrome was delayed. This led to unnecessary investigations, further relapses and increased admissions to hospital. We emphasise the need for psychiatrists to be more aware of this benign condition.