MLA Domain 5 · Presentation

Delusions

8 conditions in Finalist present this way. Work down the list and ask what would separate each one from the next — that discriminator is the exam question.

classic presentation · 3

Postpartum psychosis

ALL cases are emergencies — risk of suicide and infanticide; admit, ideally to a Mother and Baby Unit

Psychotic disorder

Risk to self/others, command hallucinations → urgent assessment

Schizoaffective disorder

Risk as per mania/depression and psychosis

recognised feature · 2

Charles Bonnet syndrome

Auditory hallucinations, delusions, fluctuating cognition or other-modality features → reconsider psychiatric/neurologic

Schizophrenia

Command hallucinations, risk to self/others, first episode → urgent EIP/specialist referral

differential of the above · 3

Baby blues

Symptoms persisting >2 weeks or worsening (postnatal depression); abrupt severe disturbance, confusion or delusions abou

Delirium

Hypoactive delirium is easily missed; a new acute confusion is delirium until proven otherwise — find the cause

Postpartum depression

Thoughts of harming the baby, psychotic features, or marked functional decline → urgent perinatal mental health referral