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Presentation comparison
EmergencyCovers mania, hypomania, mixed states, induced activation, and organic causes.
3 of 7 diagnoses compared
| CriteriaComparison detail | Bipolar I maniaEmergency |
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Sustained episodic activation plus decreased need for sleep are the key separators.
Clinical reference — not validated decision support. Review before use.
| HypomaniaEmergency |
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| Substance-induced maniaEmergency |
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| Mixed stateEmergencyNot selected |
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| Antidepressant-induced switchingEmergencyNot selected |
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| Borderline affective instabilityEmergencyNot selected |
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| Organic late-onset "mania"EmergencyNot selected |
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| Why it fits | Elevated/irritable mood, reduced need for sleep, overactivity, grandiosity, pressured speech | Less severe, no psychosis, but still clearly episodic | Stimulants, cocaine, methamphetamine, steroids, cannabis | Depression with agitation, irritability, racing thoughts, insomnia | Activation after antidepressant initiation, especially in latent bipolarity | Rapid reactive mood shifts, anger, emptiness | First manic-like presentation in later life, neurological signs, frontal disinhibition |
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| What argues against | Applies to the whole presentationReview locally. | ||||||
| Must-not-miss | Psychosis, dangerous disinhibition, financial ruin, violence, exhaustion | Escalation to mania, mixed features, impulsive harm | Hyperthermia, chest pain, prolonged psychosis, violent agitation | Very high suicide risk, abrupt escalation | |||
| Bedside question | Applies to the whole presentationSustained episodic activation plus decreased need for sleep are the key separators. | ||||||
| Immediate action | Applies to the whole presentationSleep change is one of the highest-yield discriminators Hypomania is commonly found only on careful retrospective history | ||||||
| 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.
Sustained episodic activation plus decreased need for sleep are the key separators.
Sleep change is one of the highest-yield discriminators Hypomania is commonly found only on careful retrospective history
Guided by presentation.
Review overlap locally.
Elevated/irritable mood, reduced need for sleep, overactivity, grandiosity, pressured speech
Psychosis, dangerous disinhibition, financial ruin, violence, exhaustion
Less severe, no psychosis, but still clearly episodic
Escalation to mania, mixed features, impulsive harm
Stimulants, cocaine, methamphetamine, steroids, cannabis
Hyperthermia, chest pain,
Safety first. Act early.
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Last updated: Pending review
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Create a concise comparison summary for documentation or handoff.
Source pending review
v10 | Local content only
Last updated: Pending review
| Escalating agitation, suicidality, psychosis |
| Self-harm, substance misuse, aggression |
| Stroke, brain tumour, dementia, thyrotoxicosis, corticosteroid exposure |