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Presentation comparison
UrgentCovers primary, mood-related, substance-induced, neurological, and medical causes.
1 of 9 diagnoses compared
| CriteriaComparison detail | Psychotic depressionUrgent |
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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 psychosisUrgentNot selected |
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| Autoimmune encephalitisUrgentNot selected |
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| Schizophrenia-spectrum disorderUrgentNot selected |
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| Bipolar disorder with psychosisUrgentNot 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 | Severe depression with nihilistic, somatic, guilt delusions | 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 | 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 | High suicide risk, refusal of intake, catatonia | Sepsis, hypoxia, stroke, encephalitis, medication toxicity | Hyperthermia, chest pain, violent agitation, persistent psychosis | Seizures, reduced consciousness, | |||||
| 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.
Severe depression with nihilistic, somatic, guilt delusions
High suicide risk, refusal of intake, catatonia
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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
| Command hallucinations, severe self-neglect, catatonia |
| Severe agitation, risk-taking, mixed state |
| Stalking, violence, severe treatment refusal |
| Severe self-harm, dissociation |
| Temporal lobe epilepsy, brain tumour, stroke, CNS infection |