Loading…
Presentation comparison
RoutineCovers psychiatric, cognitive, adverse-effect, trauma-related, cultural, and practical contributors.
4 of 8 diagnoses compared
| CriteriaComparison detail | Psychosis-related poor insightRoutine |
|---|
Altered reality testing drives refusal rather than simple preference.
Clinical reference — not validated decision support. Review before use.
| ManiaRoutine |
|---|
| Adverse-effect-driven non-adherenceRoutine |
|---|
| Trauma- or coercion-related refusalRoutine |
|---|
| Cognitive impairmentRoutineNot selected |
|---|
| Substance-related chaotic non-adherenceRoutineNot selected |
|---|
| StigmaRoutineNot selected |
|---|
| MalingeringRoutineNot selected |
|---|
| Why it fits | Denies illness, sees treatment as harmful/controlling/persecutory | Feels unusually well, invincible, irritable when challenged | Sedation, weight gain, sexual dysfunction, tremor, akathisia, constipation, cognitive dulling | History of retraumatising care, forced treatment, institutional mistrust | Missed doses, poor comprehension, inability to sequence regimen | Binge cycles, homelessness, poor routine, missed pharmacy | Medication feels like weakness, madness, shame, identity threat | Refusal linked to leave, housing, avoidance of discharge, medication seeking |
|---|---|---|---|---|---|---|---|---|
| What argues against | Applies to the whole presentationReview locally. | |||||||
| Must-not-miss | Refusal of essential treatment, escalating violence, severe self-neglect | Dangerous risk-taking, mixed state, psychosis, exhaustion | Severe akathisia, clozapine constipation, lithium toxicity, QT issues | Escalation with coercive approach, dissociation, | ||||
| Bedside question | Applies to the whole presentationAltered reality testing drives refusal rather than simple preference. | |||||||
| Immediate action | Applies to the whole presentationStabilise and reassess. | |||||||
| 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.
Altered reality testing drives refusal rather than simple preference.
Stabilise and reassess.
Guided by presentation.
Review overlap locally.
Denies illness, sees treatment as harmful/controlling/persecutory
Refusal of essential treatment, escalating violence, severe self-neglect
Feels unusually well, invincible, irritable when challenged
Dangerous risk-taking, mixed state, psychosis
Sedation, weight gain, sexual dysfunction, tremor, akathisia, constipation, cognitive dulling
Severe akathisia, clozapine constipation
History of retraumatising care, forced treatment, institutional mistrust
Escalation with coercive approach, dissociation
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
| Unsafe living, missed essential medicines, vulnerability |
| Withdrawal, overdose, psychotic relapse |
| Disengagement, concealment, family conflict, treatment dropout |
| Missing real psychosis, trauma, or withdrawal. Diagnosis of exclusion. |