Presentation comparison

Urgent

Hallucinations

New hallucinations need same-day assessment to separate delirium and substance causes from primary disorders.

Safety snapshot

Urgent

Usually chronic, internally generated but experienced as alien, embedded in broader psychotic syndrome.

Schizophrenia-spectrum disorder Substance-induced hallucinations Delirium

1 of 8 diagnoses compared

Edit selection

CriteriaComparison detail	Lewy body dementiaUrgent

1 of 8 comparedEdit

Safety snapshot

Urgent

Usually chronic, internally generated but experienced as alien, embedded in broader psychotic syndrome.

Schizophrenia-spectrum disorder Substance-induced hallucinations

Selected differentials (1 of 8)

+7 not selected

Open a selected differential to review its clinical record.

Lewy body dementia

Highest urgency

Based on current selection

Emergency

Safety first. Act early.

EmergencyNot selected

Delirium

Clinical reference — not validated decision support. Review before use.

Why it fits	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	Visual/mixed hallucinations with fluctuating attention, altered awareness, medical illness	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
What argues against	Applies to the whole presentationReview locally.
Must-not-miss	Marked antipsychotic sensitivity, falls, severe confusion after dopamine blockers	Malevolent command voices, severe self-neglect, violence	Hyperthermia, chest pain, severe agitation, withdrawal seizures	Sepsis, stroke, medication toxicity,
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.

Why it fits

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

Visual/mixed hallucinations with fluctuating attention, altered awareness, medical illness

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

What argues against

Applies to the whole presentationReview locally.

Must-not-miss

Marked antipsychotic sensitivity, falls, severe confusion after dopamine blockers

Malevolent command voices, severe self-neglect, violence

Hyperthermia, chest pain, severe agitation, withdrawal seizures

Sepsis, stroke, medication toxicity,

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.

Hallucinations

Safety snapshot

Safety snapshot

Selected differentials (1 of 8)

Highest urgency

Applies to the whole presentation, not to one diagnosis

What argues against

Bedside question

Immediate action

Investigations

Mimics / overlap

Why it fits

Must-not-miss

Review & handoff

Copy after review

Source status

Selected differentials (1 of 8)

Highest urgency

Review & handoff

Copy after review

Source status