Sustained mood syndrome with guilt, hopelessness, reduced energy, impaired concentration, change in sleep/appetite.
Helpful clues2 clues
Often fixed, systematised, accompanied by hallucinations, thought disorder, or negative symptoms.
Inattention and fluctuation dominate. Psychotic content is often fragmented or changeable.
Immediate action
Applies to the Depression group. Whole group
In older or medically unwell patients, assume delirium until proved otherwise Cannabis and stimulants can closely mimic primary psychosis Reassess once partially cleared Escalate early to medical/neurology review if red flags are present Consider MRI, EEG, CSF, and autoimmune testing when the syndrome is atypical Clarify positive symptoms, negative symptoms, cognition, and functional trajectory
Priority steps6 steps
1In older or medically unwell patients, assume delirium until proved otherwise
2Cannabis and stimulants can closely mimic primary psychosis
3Reassess once partially cleared
4Escalate early to medical/neurology review if red flags are present
5Consider MRI, EEG, CSF, and autoimmune testing when the syndrome is atypical
6Clarify positive symptoms, negative symptoms, cognition, and functional trajectory