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Presentation comparison
EmergencyCovers suicidal thoughts, suicide attempts, recurrent self-harm, and crisis-related risk.
4 of 7 diagnoses compared
| CriteriaComparison detail | Major depressive disorderEmergency |
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Sustained wish to die or escape, often with cognitive constriction and pessimism.
Clinical reference — not validated decision support. Review before use.
| Bipolar depressionEmergency |
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| Psychosis-driven suicidalityEmergency |
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| Borderline personality pathwayEmergency |
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| PTSDEmergencyNot selected |
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| Substance-related suicidalityEmergencyNot selected |
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| Adjustment crisisEmergencyNot selected |
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| Why it fits | Hopelessness, anhedonia, guilt, burdensomeness | Depression with agitation, irritability, racing thoughts | Command hallucinations, delusional guilt, persecutory fear | Interpersonal crisis, attachment threat, shame, emptiness | Trauma cues, flashbacks, dissociative states | Intoxication, withdrawal, or crash states | Acute stressor, often without full syndromal illness |
|---|---|---|---|---|---|---|---|
| What argues against | Applies to the whole presentationReview locally. | ||||||
| Must-not-miss | Planning, rehearsal, concealed intent, psychotic depression, high-lethality means | Mixed features, recent antidepressant activation, psychosis, substance use | Malevolent commands, high conviction, prior obedience | Escalating lethality, | |||
| Bedside question | Applies to the whole presentationSustained wish to die or escape, often with cognitive constriction and pessimism. | ||||||
| Immediate action | Applies to the whole presentationQuiet, organised suicidality is often higher risk than dramatic expression Mixed states are easy to miss and carry very high suicide risk | ||||||
| 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 wish to die or escape, often with cognitive constriction and pessimism.
Quiet, organised suicidality is often higher risk than dramatic expression Mixed states are easy to miss and carry very high suicide risk
Guided by presentation.
Review overlap locally.
Hopelessness, anhedonia, guilt, burdensomeness
Planning, rehearsal, concealed intent, psychotic depression, high-lethality means
Depression with agitation, irritability, racing thoughts
Mixed features, recent antidepressant activation,
Command hallucinations, delusional guilt, persecutory fear
Malevolent commands, high conviction,
Interpersonal crisis, attachment threat, shame, emptiness
Escalating lethality, changed method
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
| Severe dissociation, poor recall, aggressive defensive state, co-occurring substance use |
| Persistent intent after sobering, severe withdrawal, polysubstance use |
| Access to lethal means, social isolation, untreated pain, burdensomeness |