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Presentation comparison
UrgentCovers primary, mood-related, substance-induced, neurological, and medical causes.
5 of 9 diagnoses compared
| CriteriaComparison detail | DeliriumEmergency |
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Inattention and fluctuation dominate. Psychotic content is often fragmented or changeable.
Clinical reference — not validated decision support. Review before use.
| Substance-induced psychosisUrgent |
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| Autoimmune encephalitisUrgent |
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| Schizophrenia-spectrum disorderUrgent |
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| Bipolar disorder with psychosisUrgent |
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| Psychotic depressionUrgentNot selected |
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| Delusional disorderUrgentNot selected |
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| Trauma- or personality-linked psychotic-like symptomsUrgentNot selected |
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| Seizure-relatedUrgentNot selected |
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| Why it fits | New psychosis with fluctuating attention, visual hallucinations, confusion | Abrupt onset after cannabis, methamphetamine, cocaine, hallucinogens, steroids, or withdrawal | Days-to-weeks progression, confusion, catatonia, seizure, dyskinesia, autonomic instability | Persistent hallucinations, delusions, disorganisation, negative symptoms, social decline | Psychosis in context of elevated/irritable mood, reduced need for sleep | Severe depression with nihilistic, somatic, guilt delusions | Fixed non-bizarre delusion with preserved function | Stress-related, brief, state-dependent | Late-onset, atypical, olfactory phenomena, focal signs |
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| What argues against | Applies to the whole presentationReview locally. | ||||||||
| Must-not-miss | Sepsis, hypoxia, stroke, encephalitis, medication toxicity | Hyperthermia, chest pain, violent agitation, persistent psychosis | Seizures, reduced consciousness, catatonia, movement disorder, autonomic instability, hyponatraemia | ||||||
| Bedside question | Applies to the whole presentationInattention and fluctuation dominate. Psychotic content is often fragmented or changeable. | ||||||||
| Immediate action | Applies to the whole presentationIn older or medically unwell patients, assume delirium until proved otherwise Cannabis and stimulants can closely mimic primary psychosis | ||||||||
| Investigations | Applies to the whole presentationNeuroimaging (CT/MRI), EEG, Lumbar puncture / CSF studies | ||||||||
| 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.
Inattention and fluctuation dominate. Psychotic content is often fragmented or changeable.
In older or medically unwell patients, assume delirium until proved otherwise Cannabis and stimulants can closely mimic primary psychosis
Neuroimaging (CT/MRI), EEG, Lumbar puncture / CSF studies
Review overlap locally.
New psychosis with fluctuating attention, visual hallucinations, confusion
Sepsis, hypoxia, stroke, encephalitis, medication toxicity
Abrupt onset after cannabis, methamphetamine, cocaine, hallucinogens, steroids, or withdrawal
Hyperthermia, chest pain,
Days-to-weeks progression, confusion, catatonia, seizure, dyskinesia, autonomic instability
Seizures, reduced consciousness
Persistent hallucinations, delusions, disorganisation, negative symptoms, social decline
Command hallucinations, severe self-neglect
Psychosis in context of elevated/irritable mood, reduced need for sleep
Severe agitation, risk-taking,
Based on current selection
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v10 | Local content only
Last updated: Pending review
Open a selected differential to review its clinical record.
Based on current selection
Create a concise comparison summary for documentation or handoff.
Source pending review
v10 | Local content only
Last updated: Pending review
| Severe agitation, risk-taking, mixed state |
| High suicide risk, refusal of intake, catatonia |
| Stalking, violence, severe treatment refusal |
| Severe self-harm, dissociation |
| Temporal lobe epilepsy, brain tumour, stroke, CNS infection |