Differential Diagnosis of Psychosis



Differential Diagnosis of PsychosisDiagnosisCommon Age OnsetDifferentiating FeaturesSchizophreniaLate adolescence (can be older but incidence drops signficantly)Often has prodromal period80% have auditory hallucinations; most common outside, 3rd person, often multiple, often can’t identifyMost sensitive to schizophrenia: Delusions of reference, thought broadcastingOften have negative symptomsVisual hallucinations less common (15%)Not due to substance abuseEndocrine disorders (hypoglycemia/diabetes, thyroid)Often olderPhysical sxs: faint, weak, nauseated, diarrhea, thirst, frequent urinationLow blood sugarThyroid abnormalityHyperthyroid: hot, hyperactive, hair loss, sweaty, elevated blood pressure/pulseWeight gainMenstrual problemsBrain tumorAllSevere, frequent headacheBlurryNauseaFocal seizuresBrain traumaAllHistory of trauma/loss of consciousnessLevel of consciousness affectedBad headacheBlurry visionDrugsAllUsed within last weekPhysical symptoms: agitation, sweating, dry mouth, pupil changesMore insight into psychosisOften paranoid delusionsOften auditory and visual plus insightAcute onsetPTSDAllVisual hallucinations associated with traumaAuditory hallucinations- inside head, first person, remind of perpetrator, associated with negative affect/qualityDepressionAllSad affectAuditory hallucinations, mood specific, typically inside headNo prodromeMight see negative symptomsMood congruent delusionsInfectionAllTemperatureIllBipolar disorderSleeplessnessManiaGrandiosePressured speechGoal directedRespond quicker to treatment ................
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