Symptom (from Greek symptoma “anything that has befallen one”) is an each new manifestation by which some disorder is expressed. For the physician, it is a guide to diagnosis itself, and for the patient it is a signal which warns of new conditions of the body and soul or of a disorder.

Mental disorders are most commonly presented by a group of symptoms, among which the patients often can’t point out the leading one. Anxiety as a symptom can occur in a number of psychiatric entities and it can stimulate differential diagnostic dilemma in daily practice. We will show a 26-year female in which the internal anxiety is the main symptom.

To underlined the importance of taking in to account a leading symptom of the disease in the way of establishing the correct diagnosis.

The psychiatric and psychotherapeutic interviews were performed together with a clinical assessment of mental status and structured clinical interviews (SCID I and SCID II), EEG and psychological testing.

Internal discomfort is a subjective feeling, respectively a symptom which the patient in this case continuously underlined, and which guided us (along with a comprehensive analysis) to a clear diagnosis. Following the choosing of an effective psycho-pharmacological combination, and with the goal of reducing a leading symptom, according to enlarged diagnostic process, we decided to diagnose the Schizoaffective disorders (F 25.2).