Li and Miao [Phys. Rev. A 85, 042110 (2012)] proposed a non-Hermitian Hamiltonian that is neither Hermitian nor P T symmetric but exhibits real eigenvalues for some values of the model parameters. In order to explain this fact, they resorted to P T -pseudo Hermiticity and to a so-called permutation symmetry. Here we show that the spectrum of this Hamiltonian can be easily analyzed in the usual way in terms of exact or broken antiunitary symmetries that appear to be more relevant than the permutation symmetry. In addition, we show why the authors' Hamiltonian and the well-known Pais-Uhlenbeck oscillator lead to the same fourth-order differential equation for the coordinates.