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Presentation comparison
Urgent2 of 8 diagnoses compared
| CriteriaComparison detail | DeliriumEmergency |
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Usually chronic, internally generated but experienced as alien, embedded in broader psychotic syndrome.
Clinical reference — not validated decision support. Review before use.
| Schizophrenia-spectrum disorderUrgentNot selected |
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| Substance-induced hallucinationsUrgentNot selected |
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| PTSDUrgentNot selected |
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| Borderline personalityUrgentNot selected |
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| Temporal lobe epilepsyUrgentNot selected |
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| Sleep-related hallucinationsUrgentNot selected |
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| Why it fits | Visual/mixed hallucinations with fluctuating attention, altered awareness, medical illness | Recurrent well-formed visual hallucinations, fluctuation, parkinsonism, REM sleep behaviour | Persistent auditory hallucinations, commentary, dialogue, command voices | Visual, tactile, or auditory after cannabis, stimulants, hallucinogens, alcohol withdrawal, DTs | Trauma-linked voices, images, flashback-like reliving | Brief auditory hallucinations or perceptual distortions during severe stress | Olfactory, auditory, visceral, déjà vu, stereotyped and episodic | Hypnagogic/hypnopompic, or visual in visual impairment with preserved insight |
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| What argues against | Applies to the whole presentationReview locally. | |||||||
| Must-not-miss | Sepsis, stroke, medication toxicity, withdrawal states | Marked antipsychotic sensitivity, falls, severe confusion after dopamine blockers | Malevolent command voices, severe self-neglect, violence | Hyperthermia, chest pain, severe agitation, | ||||
| Bedside question | Applies to the whole presentationUsually chronic, internally generated but experienced as alien, embedded in broader psychotic syndrome. | |||||||
| Immediate action | Applies to the whole presentationDo not just ask "any voices" — clarify form, content, controllability, conviction Prominent visual or tactile hallucinations widen the toxic/organic differential | |||||||
| 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.
Usually chronic, internally generated but experienced as alien, embedded in broader psychotic syndrome.
Do not just ask "any voices" — clarify form, content, controllability, conviction Prominent visual or tactile hallucinations widen the toxic/organic differential
Guided by presentation.
Review overlap locally.
Visual/mixed hallucinations with fluctuating attention, altered awareness, medical illness
Sepsis, stroke, medication toxicity, withdrawal states
Recurrent well-formed visual hallucinations, fluctuation, parkinsonism, REM sleep behaviour
Marked antipsychotic sensitivity, falls
Safety first. Act early.
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v10 | Local content only
Last updated: Pending review
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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 dissociation, self-harm, violence |
| Concurrent self-harm, rage, dissociation |
| Cluster seizures, injury, post-ictal psychosis |
| Narcolepsy features, significant visual loss |