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Presentation comparison
UrgentCovers paranoia, thought interference, command phenomena, and trauma-related mistrust.
4 of 8 diagnoses compared
| CriteriaComparison detail | Schizophrenia-spectrum delusionsUrgent |
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Often fixed, systematised, accompanied by hallucinations, thought disorder, or negative symptoms.
Clinical reference — not validated decision support. Review before use.
| Delusional disorderUrgent |
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| Paranoid personality disorderUrgent |
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| Bipolar mania with psychosisUrgent |
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| Psychotic depressionUrgentNot selected |
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| Substance-induced threat beliefsUrgentNot selected |
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| PTSD hypervigilanceUrgentNot selected |
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| Command phenomena and internal "parts" experiencesUrgentNot selected |
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| Why it fits | Bizarre/non-bizarre persecutory, referential, grandiose, nihilistic, passivity delusions | Single/circumscribed non-bizarre delusion, preserved function outside it | Chronic distrust, guardedness, hostile attribution | Grandiose/persecutory delusions during clear mania/mixed activation | Guilt, poverty, nihilistic, deserved-punishment, severe somatic delusions | Acute persecutory/bizarre beliefs after methamphetamine, cannabis, hallucinogens, steroids, withdrawal | Fear, scanning, mistrust that is trauma-linked | Psychotic commands (external, authoritative) vs dissociative (internal, part-like) |
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| What argues against | Applies to the whole presentationReview locally. | |||||||
| Must-not-miss | Threat-to-self/others, command-linked behaviour, profound functional decline | Jealous/persecutory/erotomanic violence risk, stalking, treatment refusal | Escalating conflict, treatment refusal, retaliatory aggression | Impulsive high-lethality acts, financial/sexual risk, violence | ||||
| Bedside question | Applies to the whole presentationOften fixed, systematised, accompanied by hallucinations, thought disorder, or negative symptoms. | |||||||
| Immediate action | Applies to the whole presentationStabilise and reassess. | |||||||
| Investigations | Applies to the whole presentationGuided by presentation. | |||||||
| Mimics / overlap | Applies to the whole presentationReview overlap locally. | |||||||
Scroll horizontally to review more candidate differentials. Clinical reference — not validated decision support. Review before use.
Review locally.
Often fixed, systematised, accompanied by hallucinations, thought disorder, or negative symptoms.
Stabilise and reassess.
Guided by presentation.
Review overlap locally.
Bizarre/non-bizarre persecutory, referential, grandiose, nihilistic, passivity delusions
Threat-to-self/others, command-linked behaviour, profound functional decline
Single/circumscribed non-bizarre delusion, preserved function outside it
Jealous/persecutory/erotomanic violence risk, stalking
Chronic distrust, guardedness, hostile attribution
Escalating conflict, treatment refusal
Grandiose/persecutory delusions during clear mania/mixed activation
Impulsive high-lethality acts, financial/sexual risk
Based on current selection
Safety first. Act early.
Create a concise comparison summary for documentation or handoff.
Source pending review
v10 | Local content only
Last updated: Pending review
Open a selected differential to review its clinical record.
Based on current selection
Safety first. Act early.
Create a concise comparison summary for documentation or handoff.
Source pending review
v10 | Local content only
Last updated: Pending review
| Violence, hyperthermia, chest pain, prolonged psychosis |
| Triggered aggression, severe dissociation, self-harm |
| Commands to self-harm/harm others, reduced control, prior obedience |