Discrimination
Separating the phenomenon from the ones it is most often confused with — identifying the single feature or question that most efficiently distinguishes them.
Cognitive operation: DISTINGUISH · 185 items
Deliberate practice, not a test. Items are organised by target (phenomenon or defence) and by evidence axis. Nothing here is scored, graded or recorded — you weigh the prompt, then reveal the worked phenomenological reasoning. Fictional teaching material.
Discriminate · Abnormal Emotional Reaction vs Morbid Disorder of Emotion open
Abnormal Emotional Reaction · Morbid Disorder of Emotion
A patient's emotional response seems disproportionate. Before revealing the answer, decide what distinguishes an abnormal emotional reaction from a morbid disorder of emotion.
Discriminate · Abnormal Expression of Emotion vs Abnormal Emotional Reaction open
Abnormal Expression of Emotion · Abnormal Emotional Reaction
A patient's emotional feeling seems to differ from how it is being shown. Before revealing the answer, decide what distinguishes an abnormal expression of emotion from an abnormal emotional reaction.
Discriminate · Acute Dystonia vs Stereotyped Posture open
Acute Dystonia · Stereotyped Posture
A patient is holding an abnormal, sustained muscular posture. Before revealing the answer, decide what distinguishes acute dystonia from a catatonic stereotyped posture.
Discriminate · Blunting of Affect vs Apathy open
Blunting of Affect · Apathy
A patient seems to show less emotion and less drive than would be expected. Before revealing the answer, decide what distinguishes affect blunting from apathy.
Discriminate · Constriction of Affect vs Apathy open
Constriction of Affect · Apathy
A patient shows a limited emotional display. Before revealing the answer, decide what distinguishes constriction of affect from apathy.
Discriminate · Affective Incontinence vs Lability of Affect open
Affective Incontinence · Lability of Affect
A patient's emotional display shifts and intensifies unusually. Before revealing the answer, decide what distinguishes affective incontinence from lability of affect.
Discriminate · Agnostic Alexia vs Pure Word Deafness open
Agnostic Alexia · Pure Word Deafness
A patient shows a specific pattern of language-comprehension disturbance. Before revealing the answer, decide what distinguishes agnostic alexia from pure word deafness.
Discriminate · Akathisia vs Tardive Dyskinesia open
Akathisia · Tardive Dyskinesia
A patient on long-term antipsychotic treatment has developed abnormal movements. Before revealing the answer, decide what distinguishes akathisia from tardive dyskinesia.
Discriminate · Akinetic Mutism vs Catatonic Stupor open
Akinetic Mutism · Catatonic Stupor
A patient is unresponsive and immobile. Before revealing the answer, decide what distinguishes akinetic mutism from catatonic stupor.
Discriminate · Ambitendency vs Negativism open
Ambitendency · Negativism
A patient shows an unusual, hesitant response to a requested action. Before revealing the answer, decide what distinguishes ambitendency from negativism proper.
Discriminate · Amnesia vs Paramnesia (Distortion of Memory) open
Amnesia · Paramnesia (Distortion of Memory)
A patient has a disturbance affecting a period of personal memory. Before revealing the answer, decide what distinguishes amnesia from paramnesia.
Discriminate · Anankastic Personality Disorder vs Obsession open
Anankastic Personality Disorder · Obsession
A man spends over an hour each morning checking that his front door is locked exactly seven times, finds the checking exhausting and pointless, and wishes he could simply stop, but feels compelled to continue regardless. Is this best understood as anankastic personality disorder?
Discriminate · Anhedonia vs Apathy open
Anhedonia · Apathy
Two patients each seem to have withdrawn from activities they used to care about. Before revealing the answer, decide what question would tell anhedonia apart from apathy.
Discriminate · Anosognosia vs Denial open
Anosognosia · Denial
Two patients each seem, on the surface, to be refusing to accept that something is badly wrong. One has had a stroke and insists their paralysed arm works fine; the other has just been told they have a serious illness and keeps making long-term plans as if nothing has changed. Before revealing the answer, decide: what single question would you ask to tell these two apart at the bedside, and why?
Discriminate · Anterograde Amnesia vs Retrograde Amnesia open
Anterograde Amnesia · Retrograde Amnesia
A patient with a head injury has a memory gap. Before revealing the answer, decide what single question settles whether this is anterograde or retrograde amnesia.
Discriminate · Movement Disorders Associated with Antipsychotic Medication vs Catatonic Stupor open
Movement Disorders Associated with Antipsychotic Medication · Catatonic Stupor
A patient started on an antipsychotic ten days ago becomes stiff and restless, pacing the ward and unable to sit still, describing an unpleasant inner tension. A second patient, with no recent medication change, sits motionless for hours with a blank, deadpan expression, lively eyes, and a limb that remains fixed in whatever position it is placed. Are both of these best understood as antipsychotic-induced movement disorder?
Discriminate · Anxiety Amnesia vs Dissociative Amnesia open
Anxiety Amnesia · Dissociative Amnesia
A patient reports memory difficulty in the context of a mood or anxiety disturbance. Before revealing the answer, decide what distinguishes anxiety amnesia from dissociative amnesia.
Discriminate · Anxiety vs Panic Attack open
Anxiety · Panic Attack
A patient describes apprehension along with physical symptoms such as a racing heart and sweating. Before revealing the answer, decide what distinguishes anxiety from a panic attack.
Discriminate · Anxious Foreboding vs Panic Attack open
Anxious Foreboding · Panic Attack
A patient describes fear about the future. Before revealing the answer, decide what distinguishes anxious foreboding from a panic attack.
Discriminate · Anxious Personality Disorder vs Schizoid Personality Disorder open
Anxious Personality Disorder · Schizoid Personality Disorder
A patient describes long-standing social isolation. Before revealing the answer, decide what distinguishes anxious (avoidant) personality disorder from schizoid personality disorder.
Discriminate · Apathy vs Demoralization open
Apathy · Demoralization
A patient shows reduced engagement and motivation. Before revealing the answer, decide what distinguishes apathy from demoralization.
Discriminate · Auditory Hallucination vs Pseudohallucination open
Auditory Hallucination · Pseudohallucination
A patient describes hearing something with no external source. Before revealing the answer, decide what distinguishes a true auditory hallucination from a pseudohallucination.
Discriminate · Autochthonous Delusion (Sudden Delusional Idea) vs Delusional Perception open
Autochthonous Delusion (Sudden Delusional Idea) · Delusional Perception
A patient suddenly develops a fixed, false belief. Before revealing the answer, decide what distinguishes an autochthonous delusion from a delusional perception.
Discriminate · Automatic Obedience vs Cooperation (Mitmachen) and Mitgehen open
Automatic Obedience · Cooperation (Mitmachen) and Mitgehen
A patient shows an unusual degree of compliance during a motor examination. Before revealing the answer, decide what distinguishes automatic obedience from Mitmachen and Mitgehen.
Discriminate · Autoscopy vs Depersonalisation open
Autoscopy · Depersonalisation
A patient describes an unsettling sense of being detached from themselves. Before revealing the answer, decide what single question distinguishes autoscopy from depersonalisation.
Discriminate · La Belle Indifférence vs Denial open
La Belle Indifférence · Denial
A patient with a striking physical symptom seems remarkably unbothered by it. Before revealing the answer, decide what distinguishes la belle indifference from denial.
Discriminate · Body Image Disturbance vs Nihilistic Delusion open
Body Image Disturbance · Nihilistic Delusion
A patient describes an abnormal experience involving part of their body. Before revealing the answer, decide what distinguishes body image disturbance from a nihilistic delusion.
Discriminate · Borderline Personality Disorder vs Dissocial Personality Disorder open
Borderline Personality Disorder · Dissocial Personality Disorder
Two patients each have a history of intense relationships, impulsivity, and difficulty with other people. Before revealing the answer, decide what would tell borderline personality disorder apart from dissocial personality disorder.
Discriminate · Catalepsy vs Waxy Flexibility open
Catalepsy · Waxy Flexibility
A patient's limb stays where it is placed during a motor examination. Before revealing the answer, decide what distinguishes catalepsy from waxy flexibility.
Discriminate · Catathymic Amnesia vs Dissociative Amnesia open
Catathymic Amnesia · Dissociative Amnesia
A patient cannot recall a distressing part of her past. Before revealing the answer, decide what distinguishes catathymic amnesia from dissociative amnesia.
Discriminate · Catatonic Speech Disturbance vs Talking Past the Point (Vorbeireden) open
Catatonic Speech Disturbance · Talking Past the Point (Vorbeireden)
A patient's speech sounds unusual. Before revealing the answer, decide what distinguishes catatonic speech disturbance from talking past the point.
Discriminate · Catatonic Stupor vs Depressive Stupor open
Catatonic Stupor · Depressive Stupor
Two patients present in a profound stupor, barely responsive to their surroundings. Before revealing the answer, name the bedside features you would check to tell catatonic stupor apart from depressive stupor.
Discriminate · Central Aphasia vs Receptive Aphasia open
Central Aphasia · Receptive Aphasia
A patient shows a substantial language disturbance. Before revealing the answer, decide what distinguishes central aphasia from receptive aphasia.
Discriminate · Chromatopsia vs Visual Hallucination open
Chromatopsia · Visual Hallucination
A patient describes an abnormal visual experience. Before revealing the answer, decide what distinguishes chromatopsia from a visual hallucination.
Discriminate · Circumstantiality vs Flight of Ideas open
Circumstantiality · Flight of Ideas
A patient's speech takes a long, roundabout path before reaching a point. Before revealing the answer, decide what distinguishes circumstantiality from flight of ideas.
Discriminate · Compulsion vs Obsession open
Compulsion · Obsession
A patient describes a repetitive urge and an accompanying repetitive action. Before revealing the answer, decide what distinguishes a compulsion from an obsession.
Discriminate · Confabulation vs Pseudologia Fantastica open
Confabulation · Pseudologia Fantastica
Two patients each tell detailed, inaccurate stories about their recent activities. Before revealing the answer, decide what you would ask to tell confabulation apart from pseudologia fantastica.
Discriminate · Cryptamnesia vs Confabulation open
Cryptamnesia · Confabulation
A patient produces content that turns out not to be a genuinely new creation. Before revealing the answer, decide what distinguishes cryptamnesia from confabulation.
Discriminate · Déjà Vu vs Cryptamnesia open
Déjà Vu · Cryptamnesia
Two patients each describe a mismatch between what actually happened and how familiar or new it felt. Before revealing the answer, decide what direction of mismatch tells déjà vu apart from cryptamnesia.
Discriminate · Delusion of Guilt vs Nihilistic Delusion open
Delusion of Guilt · Nihilistic Delusion
Both a delusion of guilt and a nihilistic delusion are classically seen in the most severe presentations of depressive illness and often occur together. A patient says: "I don't exist anymore, I'm already dead, there's nothing left of me." Is this a delusion of guilt?
Discriminate · Delusion of Ill Health vs Overvalued Idea open
Delusion of Ill Health · Overvalued Idea
A patient has for several years been intensely preoccupied with the idea that she has an undiagnosed heart condition, has read extensively about cardiac disease, and dominates most conversations with this concern — but when a cardiologist she trusts spends time carefully reviewing her results with her, she becomes, at least temporarily, somewhat reassured. Is this a delusion of ill health?
Discriminate · Delusion of Infidelity vs Delusion of Persecution open
Delusion of Infidelity · Delusion of Persecution
A man becomes convinced that his neighbours are conspiring against him, monitoring his movements, and have poisoned his water supply. Separately, he has also become convinced his wife is secretly meeting other men, based on the same generalised sense of being watched. Which delusion is the water-supply belief?
Discriminate · Grandiose Delusion vs Delusion of Love open
Grandiose Delusion · Delusion of Love
A woman with elevated mood believes both that she has been specially chosen to write the definitive theory unifying physics, and that a famous physicist she has never met is secretly in love with her and communicating this through television interviews. Which of these two beliefs is the grandiose delusion?
Discriminate · Delusion of Persecution vs Delusional Perception open
Delusion of Persecution · Delusional Perception
A patient holds a persecutory belief. Before revealing the answer, decide what distinguishes a delusion of persecution from delusional perception.
Discriminate · Delusion of Poverty vs Delusion of Guilt open
Delusion of Poverty · Delusion of Guilt
Delusions of poverty and guilt often occur together as part of the same severe depressive delusional constellation, alongside delusions of ill health. A patient with severe depressive illness says: "We'll have nothing left, I've ruined the family financially, we'll be on the streets." Is this a delusion of guilt?
Discriminate · Delusion vs Secondary Delusion open
Delusion · Secondary Delusion
A patient holds a false, fixed belief. Before revealing the answer, decide what distinguishes a primary delusion from a secondary (delusion-like) idea.
Discriminate · Delusional Mood vs Delusional Perception open
Delusional Mood · Delusional Perception
A patient describes an unsettling sense that something significant is happening. Before revealing the answer, decide what distinguishes delusional mood from delusional perception.
Discriminate · Delusional Perception vs Overvalued Idea open
Delusional Perception · Overvalued Idea
Two patients each hold a strange, fixed belief with great confidence. Before revealing the answer, decide what would help you tell a delusional perception apart from an overvalued idea.
Discriminate · Denial vs Dissociation of Affect open
Denial · Dissociation of Affect
A patient discusses a distressing situation without the expected emotional reaction. Before revealing the answer, decide what distinguishes denial from dissociation of affect.
Discriminate · Dependent Personality Disorder vs Histrionic Personality Disorder open
Dependent Personality Disorder · Histrionic Personality Disorder
Two patients both seem to organise their lives around other people's attention and approval. Before revealing the answer, decide what distinguishes dependent personality disorder from histrionic personality disorder.
Discriminate · Depersonalisation vs Nihilistic Delusion open
Depersonalisation · Nihilistic Delusion
Two patients each describe, in their own way, 'not really existing.' Before revealing the answer, decide what single question best separates depersonalisation from a nihilistic delusion.
Discriminate · Depressive Illness vs Demoralization open
Depressive Illness · Demoralization
A patient describes persistent low mood related to difficult circumstances. Before revealing the answer, decide what distinguishes a depressive illness from demoralization.
Discriminate · Depressive Pseudodementia vs Amnestic State open
Depressive Pseudodementia · Amnestic State
One patient develops broad difficulty with memory, concentration, and everyday tasks alongside a severe, unmistakable low mood, is acutely distressed by her own decline, and recovers her cognitive function almost completely once the depression is treated. A second patient, following a head injury with no mood disturbance at all, cannot learn or recall any new information from the day of the injury onward, while his other cognitive abilities, immediate recall, and memories from before the injury all remain intact. Are both of these best understood as depressive pseudodementia?
Discriminate · Depressive Stupor vs Psychomotor Retardation open
Depressive Stupor · Psychomotor Retardation
A severely depressed patient shows profound slowing. Before revealing the answer, decide what distinguishes depressive stupor from psychomotor retardation more broadly.
Discriminate · Derealisation vs Depersonalisation open
Derealisation · Depersonalisation
A patient describes a pervasive sense of unreality but hasn't specified exactly what feels unreal. Before revealing the answer, decide what single question separates derealisation from depersonalisation.
Discriminate · Desultory Thinking vs Transitory Thinking open
Desultory Thinking · Transitory Thinking
A patient's train of thought is repeatedly disrupted mid-course. Before revealing the answer, decide what distinguishes desultory thinking from transitory thinking.
Discriminate · Disorders of Expressive Movement vs Blunting of Affect open
Disorders of Expressive Movement · Blunting of Affect
A patient shows a reduced range of movement accompanying their emotional expression. Before revealing the answer, decide what distinguishes a disorder of expressive movement from blunting of affect.
Discriminate · Disorientation vs Perplexity open
Disorientation · Perplexity
A patient seems confused during assessment. Before revealing the answer, decide what distinguishes disorientation from perplexity.
Discriminate · Dissocial Personality Disorder vs Borderline Personality Disorder open
Dissocial Personality Disorder · Borderline Personality Disorder
A patient has a long history of turbulent relationships and behaviour that has harmed others. Before revealing the answer, decide what distinguishes dissocial personality disorder from borderline personality disorder, especially since the two can be confused, particularly in women.
Discriminate · Dissociation of Affect vs Blunting of Affect open
Dissociation of Affect · Blunting of Affect
A patient shows a mismatch between emotionally significant content and the feeling displayed. Before revealing the answer, decide what distinguishes dissociation of affect from affect blunting.
Discriminate · Distortion of Recall vs Distortion of Recognition open
Distortion of Recall · Distortion of Recognition
A patient's memory has been affected in some way. Before revealing the answer, decide what distinguishes distortion of recall from distortion of recognition.
Discriminate · Distractibility vs Thought Blocking open
Distractibility · Thought Blocking
A patient's train of thought or speech is repeatedly interrupted. Before revealing the answer, decide what distinguishes distractibility from thought blocking.
Discriminate · Disturbance of Consciousness vs Lowering of Consciousness open
Disturbance of Consciousness · Lowering of Consciousness
A patient following a head injury is drowsy, responds only to loud voice or firm touch, and drifts back toward sleep whenever not actively stimulated, with no dream-like or fluctuating quality to the presentation. Is the correct, most specific term here simply "a disturbance of consciousness"?
Discriminate · Disturbance of Awareness of Self-Activity vs Nihilistic Delusion open
Disturbance of Awareness of Self-Activity · Nihilistic Delusion
A patient describes a profound, distressing change in how their own existence feels. Before revealing the answer, decide what distinguishes disturbance of awareness of self-activity from a nihilistic delusion.
Discriminate · Disturbance of the Boundaries of the Self vs Disturbance of Awareness of Self-Activity open
Disturbance of the Boundaries of the Self · Disturbance of Awareness of Self-Activity
A patient describes a disturbed relationship between themselves and their thoughts or actions. Before revealing the answer, decide what distinguishes disturbance of the boundaries of the self from disturbance of awareness of self-activity.
Discriminate · Disturbance of the Continuity of Self vs Disturbance of the Immediate Awareness of Self-Unity open
Disturbance of the Continuity of Self · Disturbance of the Immediate Awareness of Self-Unity
A patient describes a disturbed sense of who they are. Before revealing the answer, decide what distinguishes a disturbance of the continuity of self from a disturbance of self-unity.
Discriminate · Disturbance of the Immediate Awareness of Self-Unity vs Passivity Phenomena open
Disturbance of the Immediate Awareness of Self-Unity · Passivity Phenomena
A patient describes something unsettling about the sense that their actions belong to them. Before revealing the answer, decide what distinguishes disturbance of self-unity from a passivity phenomenon.
Discriminate · Dream-Like Change of Consciousness vs Lowering of Consciousness open
Dream-Like Change of Consciousness · Lowering of Consciousness
Two elderly patients each show some disturbance of consciousness following an acute physical illness. Before revealing the answer, decide what single feature best separates a dream-like change of consciousness from lowering of consciousness.
Discriminate · Drivelling Thinking vs Desultory Thinking open
Drivelling Thinking · Desultory Thinking
A patient's explanation of a complex idea does not come out coherently. Before revealing the answer, decide what distinguishes drivelling thinking from desultory thinking.
Discriminate · Dysmegalopsia vs Visual Hallucination open
Dysmegalopsia · Visual Hallucination
A patient describes a distorted visual experience. Before revealing the answer, decide what distinguishes dysmegalopsia from a visual hallucination.
Discriminate · Echolalia vs Perseveration open
Echolalia · Perseveration
A patient repeats something during the interview. Before revealing the answer, decide what distinguishes echolalia from perseveration.
Discriminate · Echopraxia vs Echolalia open
Echopraxia · Echolalia
A patient with catatonia seems to be automatically copying the interviewer. Before revealing the answer, decide what would tell you whether this is echopraxia or echolalia.
Discriminate · Ecstasy vs Morbid Euphoria open
Ecstasy · Morbid Euphoria
A patient describes an abnormally elevated mood. Before revealing the answer, decide what distinguishes ecstasy from morbid euphoria.
Discriminate · Eidetic Imagery vs Visual Hallucination open
Eidetic Imagery · Visual Hallucination
A patient describes an unusually vivid visual experience. Before revealing the answer, decide what distinguishes eidetic imagery from a visual hallucination.
Discriminate · Emotionally Unstable Personality Disorder vs Borderline Personality Disorder open
Emotionally Unstable Personality Disorder · Borderline Personality Disorder
A clinician is describing a patient's personality pattern. Before revealing the answer, decide what distinguishes emotionally unstable personality disorder from borderline personality disorder specifically.
Discriminate · Enduring Personality Change after a Catastrophic Experience vs Personality Disorder open
Enduring Personality Change after a Catastrophic Experience · Personality Disorder
A patient shows a lasting change in character following a severe stressor. Before revealing the answer, decide what distinguishes enduring personality change after a catastrophic experience from a personality disorder in the general sense.
Discriminate · Excitement vs Pathological Drunkenness open
Excitement · Pathological Drunkenness
A patient shows markedly increased motor activity. Before revealing the answer, decide what distinguishes excitement in general from pathological drunkenness specifically.
Discriminate · Expressive Aphasia vs Mutism open
Expressive Aphasia · Mutism
A patient's spoken output is severely reduced. Before revealing the answer, decide what distinguishes expressive aphasia from mutism.
Discriminate · Extracampine Hallucination vs Hallucination open
Extracampine Hallucination · Hallucination
A patient describes a hallucinatory perception. Before revealing the answer, decide what specifically distinguishes an extracampine hallucination from a hallucination more generally.
Discriminate · False Memory vs Retrospective Falsification open
False Memory · Retrospective Falsification
A patient's account of a past event turns out to be inaccurate. Before revealing the answer, decide what distinguishes a false memory from retrospective falsification.
Discriminate · False Reconnaissance vs Capgras Syndrome open
False Reconnaissance · Capgras Syndrome
A patient fails to recognise someone they genuinely know. Before revealing the answer, decide what distinguishes false reconnaissance from Capgras syndrome.
Discriminate · Flashback vs Flashbulb Memory open
Flashback · Flashbulb Memory
A patient describes an unusually vivid memory of a significant past event. Before revealing the answer, decide what distinguishes a flashback from a flashbulb memory.
Discriminate · Flight of Ideas vs Circumstantiality open
Flight of Ideas · Circumstantiality
A patient takes a long, winding route through many side-topics before finishing their answer. Before revealing the answer, decide what would tell flight of ideas apart from circumstantiality.
Discriminate · Forced Grasping vs Automatic Obedience open
Forced Grasping · Automatic Obedience
A patient's behaviour does not match a given instruction. Before revealing the answer, decide what distinguishes forced grasping from automatic obedience.
Discriminate · Formal Thought Disorder vs Flight of Ideas open
Formal Thought Disorder · Flight of Ideas
A patient's speech is difficult to follow. Before revealing the answer, decide what distinguishes formal thought disorder from flight of ideas.
Discriminate · Functional Hallucination vs Reflex Hallucination open
Functional Hallucination · Reflex Hallucination
Two patients each describe a real sound reliably triggering a hallucination. Before revealing the answer, decide what single question tells a functional hallucination apart from a reflex hallucination.
Discriminate · Ganser Syndrome vs Talking Past the Point (Vorbeireden) open
Ganser Syndrome · Talking Past the Point (Vorbeireden)
A patient consistently gives approximate, noticeably wrong answers to simple questions. Before revealing the answer, decide what distinguishes Ganser syndrome from talking past the point in general.
Discriminate · Gegenhalten (Opposition) vs Cooperation (Mitmachen) and Mitgehen open
Gegenhalten (Opposition) · Cooperation (Mitmachen) and Mitgehen
You are examining a patient's response to passive limb movement. Before revealing the answer, decide what distinguishes Gegenhalten (opposition) from Mitmachen and Mitgehen.
Discriminate · Gustatory Hallucination vs Olfactory Hallucination open
Gustatory Hallucination · Olfactory Hallucination
A patient reports both an unusual taste and an unusual smell with nothing present to account for either. Before revealing the answer, decide what distinguishes a gustatory hallucination from an olfactory hallucination.
Discriminate · Hallucination vs Illusion open
Hallucination · Illusion
A patient reports an unusual perceptual experience. Before revealing the answer, decide what distinguishes a hallucination from an illusion.
Discriminate · Hallucinosis vs Disturbance of Consciousness open
Hallucinosis · Disturbance of Consciousness
One patient with a long history of heavy alcohol use reports hearing hostile voices for several days, while remaining fully oriented, coherent, and able to give an accurate, detailed account of recent events. A second patient, following a severe chest infection, appears muddled, cannot reliably say where he is, occasionally seems to misperceive staff as figures from his past, and drifts in and out of clear awareness of his surroundings. Are both of these best understood as hallucinosis?
Discriminate · Hemiasomatognosia vs Somatoparaphrenia open
Hemiasomatognosia · Somatoparaphrenia
A patient with a right hemisphere lesion shows an odd relationship to their left limb. Before revealing the answer, decide what distinguishes hemiasomatognosia from somatoparaphrenia.
Discriminate · Hemispatial Neglect vs Hemiasomatognosia open
Hemispatial Neglect · Hemiasomatognosia
A patient fails to attend to one side following a right parietal lesion. Before revealing the answer, decide what distinguishes hemispatial neglect from hemiasomatognosia.
Discriminate · Histrionic Personality Disorder vs Dependent Personality Disorder open
Histrionic Personality Disorder · Dependent Personality Disorder
Two patients each seem to organise much of their life around securing other people's attention and care, but in very different styles — one dramatic and demanding centre stage, the other quiet and compliant. Before revealing the answer, decide which is histrionic and which is dependent personality disorder, and what tells them apart.
Discriminate · Hyperamnesia vs Confabulation open
Hyperamnesia · Confabulation
A patient describes an unusually vivid memory. Before revealing the answer, decide what distinguishes hyperamnesia from confabulation.
Discriminate · Hypnagogic Hallucination vs Hallucination open
Hypnagogic Hallucination · Hallucination
A person reports a brief, vivid sensory experience with no real stimulus. Before revealing the answer, decide what distinguishes a hypnagogic hallucination from a hallucination occurring during ordinary wakefulness.
Discriminate · Hysterical Twilight State vs Twilight State open
Hysterical Twilight State · Twilight State
A patient has had an episode matching the pattern of a twilight state. Before revealing the answer, decide what distinguishes a hysterical (dissociative) twilight state from an organic one.
Discriminate · Impulsive Behaviour vs Extended Suicide open
Impulsive Behaviour · Extended Suicide
A patient suddenly carries out a violent act. Before revealing the answer, decide what distinguishes impulsive behaviour from extended suicide.
Discriminate · Impulsive Personality Disorder vs Irritability open
Impulsive Personality Disorder · Irritability
A patient shows a pattern of quick, disproportionate anger. Before revealing the answer, decide what distinguishes impulsive personality disorder from irritability.
Discriminate · Incongruity of Affect vs Blunting of Affect open
Incongruity of Affect · Blunting of Affect
Two patients each seem to show 'the wrong amount' of emotion during an interview. Before revealing the answer, decide what would tell incongruity of affect apart from blunting of affect.
Discriminate · Inhibition (Slowing) of Thinking vs Thought Blocking open
Inhibition (Slowing) of Thinking · Thought Blocking
A patient's thinking seems disrupted. Before revealing the answer, decide what distinguishes inhibition of thinking from thought blocking.
Discriminate · Intermediate Aphasia vs Nominal Aphasia open
Intermediate Aphasia · Nominal Aphasia
A patient shows a specific, more circumscribed language disturbance. Before revealing the answer, decide what distinguishes intermediate aphasia from nominal aphasia specifically.
Discriminate · Involuntary Neurological Movement Signs vs Tardive Dyskinesia open
Involuntary Neurological Movement Signs · Tardive Dyskinesia
A patient shows an involuntary movement pattern with a possible medication history. Before revealing the answer, decide what distinguishes the broader family of involuntary neurological movement signs from tardive dyskinesia specifically.
Discriminate · Irritability vs Affective Incontinence open
Irritability · Affective Incontinence
A patient shows a heightened emotional reactivity. Before revealing the answer, decide what distinguishes irritability from affective incontinence.
Discriminate · Lability of Affect vs Stiffening of Affect open
Lability of Affect · Stiffening of Affect
A patient's emotional display seems abnormal, but you're not sure in which direction. Before revealing the answer, decide what distinguishes lability of affect from stiffening of affect.
Discriminate · Lethologia vs Nominal Aphasia open
Lethologia · Nominal Aphasia
A person has difficulty recalling a name. Before revealing the answer, decide what distinguishes lethologia from nominal aphasia.
Discriminate · Loss of Emotional Resonance vs Blunting of Affect open
Loss of Emotional Resonance · Blunting of Affect
A patient describes a reduced emotional response. Before revealing the answer, decide what distinguishes loss of emotional resonance from affect blunting.
Discriminate · Lowering of Consciousness vs Restriction of Consciousness open
Lowering of Consciousness · Restriction of Consciousness
Two patients each show some disturbance of consciousness following an acute event, without any hallucinations. Before revealing the answer, decide what would tell lowering of consciousness apart from restriction of consciousness.
Discriminate · Mannerisms vs Stereotyped Posture open
Mannerisms · Stereotyped Posture
A patient repeatedly performs an unusual movement. Before revealing the answer, decide what would tell a mannerism apart from a stereotyped posture.
Discriminate · Cooperation (Mitmachen) and Mitgehen vs Waxy Flexibility open
Cooperation (Mitmachen) and Mitgehen · Waxy Flexibility
A patient's limb can be passively moved with no resistance. Before revealing the answer, decide what distinguishes Mitmachen from waxy flexibility.
Discriminate · Morbid Anxiety vs Anxiety open
Morbid Anxiety · Anxiety
A patient reports feeling anxious much of the time. Before revealing the answer, decide what distinguishes morbid anxiety from anxiety as an ordinary emotional reaction.
Discriminate · Morbid Disorder of Emotion vs Morbid Expression of Emotion open
Morbid Disorder of Emotion · Morbid Expression of Emotion
A patient shows a significant disturbance of emotion. Before revealing the answer, decide what distinguishes a morbid disorder of emotion from a morbid expression of emotion.
Discriminate · Morbid Expression of Emotion vs Abnormal Expression of Emotion open
Morbid Expression of Emotion · Abnormal Expression of Emotion
A patient's outward display of emotion has changed in a way others have noticed. Before revealing the answer, decide what distinguishes a morbid expression of emotion from an abnormal expression of emotion.
Discriminate · Moria vs Morbid Euphoria open
Moria · Morbid Euphoria
A patient shows an abnormally elevated mood. Before revealing the answer, decide what distinguishes moria from morbid euphoria.
Discriminate · Motor and Verbal Perseveration vs Perseveration open
Motor and Verbal Perseveration · Perseveration
A patient, asked a question about his name, answers correctly. Asked next what year it is, he again says his own name. Is this motor perseveration?
Discriminate · Experience of Multiple Personalities vs Disturbance of the Immediate Awareness of Self-Unity open
Experience of Multiple Personalities · Disturbance of the Immediate Awareness of Self-Unity
A patient describes an unusual experience of self. Before revealing the answer, decide what distinguishes the experience of multiple personalities from a disturbance of self-unity.
Discriminate · Munchausen's Syndrome vs Pseudologia Fantastica open
Munchausen's Syndrome · Pseudologia Fantastica
A patient shows a pattern of elaborate, fluent false stories. Before revealing the answer, decide what distinguishes Munchausen's syndrome from pseudologia fantastica more broadly.
Discriminate · Mutism vs Pure Word-Dumbness open
Mutism · Pure Word-Dumbness
A patient has stopped speaking entirely. Before revealing the answer, decide what distinguishes general mutism from the specific pattern of pure word-dumbness.
Discriminate · Narcissistic Personality Disorder vs Histrionic Personality Disorder open
Narcissistic Personality Disorder · Histrionic Personality Disorder
Two patients each seem to crave a great deal of attention from others. Before revealing the answer, decide what would help you tell narcissistic personality disorder apart from histrionic personality disorder.
Discriminate · Negativism vs Gegenhalten (Opposition) open
Negativism · Gegenhalten (Opposition)
A patient resists passive movement or instructions during examination. Before revealing the answer, decide what distinguishes negativism from Gegenhalten.
Discriminate · Neologism vs Paraphasia open
Neologism · Paraphasia
A patient uses an unusual, non-standard word. Before revealing the answer, decide what distinguishes a neologism from a paraphasia.
Discriminate · Nihilistic Delusion vs Anosognosia open
Nihilistic Delusion · Anosognosia
A patient makes a striking claim about his own body. Before revealing the answer, decide what distinguishes a nihilistic delusion from anosognosia.
Discriminate · Nominal Aphasia vs Central Aphasia open
Nominal Aphasia · Central Aphasia
A patient shows a specific pattern of aphasic language disturbance. Before revealing the answer, decide what distinguishes nominal aphasia from central aphasia.
Discriminate · Obsession vs Thought Insertion open
Obsession · Thought Insertion
A patient describes an unwanted thought that keeps intruding into their mind. Before revealing the answer, decide what single question distinguishes an obsession from thought insertion.
Discriminate · Obstruction (Blocking) vs Psychomotor Retardation open
Obstruction (Blocking) · Psychomotor Retardation
A patient's movements are slowed or hindered. Before revealing the answer, decide what distinguishes obstruction from psychomotor retardation.
Discriminate · Occupational Delirium vs Mannerisms open
Occupational Delirium · Mannerisms
A patient performs an unusual repetitive movement. Before revealing the answer, decide what distinguishes occupational delirium from a mannerism.
Discriminate · Organic Amnesia vs Dissociative Amnesia open
Organic Amnesia · Dissociative Amnesia
A patient presents with significant memory loss. Before revealing the answer, decide what distinguishes organic amnesia from dissociative amnesia.
Discriminate · Organic Hallucination vs Functional Hallucination open
Organic Hallucination · Functional Hallucination
A patient describes a persistent hallucination with a plausible physical explanation. Before revealing the answer, decide what distinguishes an organic hallucination from a functional hallucination.
Discriminate · Overvalued Idea vs Delusion open
Overvalued Idea · Delusion
A patient holds a belief with strong, persistent conviction. Before revealing the answer, decide what distinguishes an overvalued idea from a delusion.
Discriminate · Panic Attack vs Phobia open
Panic Attack · Phobia
A patient describes episodes of intense fear. Before revealing the answer, decide what distinguishes a panic attack from a phobic reaction.
Discriminate · Paramnesia (Distortion of Memory) vs Amnesia open
Paramnesia (Distortion of Memory) · Amnesia
A patient's account of the past seems unreliable. Before revealing the answer, decide what distinguishes a paramnesia from amnesia.
Discriminate · Paranoid Personality Disorder vs Delusion of Infidelity open
Paranoid Personality Disorder · Delusion of Infidelity
A man has, for as long as his wife can remember, been generally suspicious of colleagues, neighbours, and now increasingly of her — but recently this has crystallised into an absolutely fixed, unshakeable conviction, unaltered by any reassurance or evidence, that she is having a specific ongoing affair with a named colleague. Is the fixed belief about the affair itself best understood simply as part of his paranoid personality disorder?
Discriminate · Paraschemazia vs Somatoparaphrenia open
Paraschemazia · Somatoparaphrenia
A patient describes an unusual, distressing change in how a body part feels. Before revealing the answer, decide what distinguishes paraschemazia from somatoparaphrenia.
Discriminate · Passivity Phenomena vs Thought Withdrawal open
Passivity Phenomena · Thought Withdrawal
A patient describes a disturbing sense that something is being taken away or controlled by an outside force. Before revealing the answer, decide what distinguishes a passivity phenomenon from thought withdrawal.
Discriminate · Perplexity vs Anxious Foreboding open
Perplexity · Anxious Foreboding
A patient appears distressed and unsettled about their current experience. Before revealing the answer, decide what distinguishes perplexity from anxious foreboding.
Discriminate · Perseveration of Posture vs Waxy Flexibility open
Perseveration of Posture · Waxy Flexibility
A patient's limb, once placed in an unusual position, remains there for an extended period. Before revealing the answer, decide what distinguishes perseveration of posture from waxy flexibility.
Discriminate · Perseveration vs Verbal Stereotypy open
Perseveration · Verbal Stereotypy
A patient repeats the same word or phrase more than once during an assessment. Before revealing the answer, decide what distinguishes perseveration from verbal stereotypy.
Discriminate · Phobia vs Anxiety open
Phobia · Anxiety
A patient describes a fear response. Before revealing the answer, decide what distinguishes a phobia from generalised anxiety.
Discriminate · Primary Delusion vs Secondary Delusion open
Primary Delusion · Secondary Delusion
A patient holds a fixed, false belief. Before revealing the answer, decide what single question distinguishes a primary delusion from a secondary one.
Discriminate · Pseudohallucination vs Hallucination open
Pseudohallucination · Hallucination
A patient describes seeing something that isn't there. Before revealing the answer, decide what two questions would tell a pseudohallucination apart from a true hallucination.
Discriminate · Pure Word Deafness vs Visual Asymbolia open
Pure Word Deafness · Visual Asymbolia
A patient shows a specific pattern of language comprehension disturbance. Before revealing the answer, decide what distinguishes pure word deafness from visual asymbolia.
Discriminate · Pure Word-Dumbness vs Expressive Aphasia open
Pure Word-Dumbness · Expressive Aphasia
A patient produces no spoken output at all. Before revealing the answer, decide what distinguishes pure word-dumbness from expressive aphasia.
Discriminate · Disorders of Reactive Movements vs Negativism open
Disorders of Reactive Movements · Negativism
A patient shows an unusual pattern of responsiveness to stimuli in their environment. Before revealing the answer, decide what distinguishes a disorder of reactive movements from negativism.
Discriminate · Reactivity of Mood vs Lability of Affect open
Reactivity of Mood · Lability of Affect
A patient's mood shows frequent, marked shifts. Before revealing the answer, decide what distinguishes reactivity of mood from lability of affect.
Discriminate · Receptive Aphasia vs Expressive Aphasia open
Receptive Aphasia · Expressive Aphasia
A patient shows an aphasic language disturbance. Before revealing the answer, decide what distinguishes receptive aphasia from expressive aphasia.
Discriminate · Reflex Hallucination vs Synaesthesia open
Reflex Hallucination · Synaesthesia
A stimulus in one sense reliably triggers an experience in a different sense. Before revealing the answer, decide what distinguishes a reflex hallucination from synaesthesia.
Discriminate · Restriction of Consciousness vs Dream-Like Change of Consciousness open
Restriction of Consciousness · Dream-Like Change of Consciousness
A patient shows disorientation with an altered level of consciousness. Before revealing the answer, decide what distinguishes restriction of consciousness from a dream-like change of consciousness.
Discriminate · Retrograde Amnesia vs Anterograde Amnesia open
Retrograde Amnesia · Anterograde Amnesia
A patient with a head injury has a memory gap. Before revealing the answer, decide what single question settles whether this is retrograde or anterograde amnesia.
Discriminate · Retrospective Delusion vs Retrospective Falsification open
Retrospective Delusion · Retrospective Falsification
A patient's account of their own past has been altered to fit their current state. Before revealing the answer, decide what distinguishes a retrospective delusion from retrospective falsification.
Discriminate · Retrospective Falsification vs Confabulation open
Retrospective Falsification · Confabulation
A patient's account of their past does not match what actually happened. Before revealing the answer, decide what distinguishes retrospective falsification from confabulation.
Discriminate · Ribot's Law of Memory Regression vs Amnestic State open
Ribot's Law of Memory Regression · Amnestic State
A patient shows a marked pattern of memory loss. Before revealing the answer, decide what distinguishes Ribot's law of memory regression from an amnestic state.
Discriminate · Running Commentary Voices vs Thought Echo open
Running Commentary Voices · Thought Echo
A patient describes hearing a voice that seems tightly linked to what they are doing or thinking. Before revealing the answer, decide what single question distinguishes running commentary voices from thought echo.
Discriminate · Schemazia Distortion vs Anosognosia open
Schemazia Distortion · Anosognosia
A patient describes a felt change in how large a body part seems. Before revealing the answer, decide what distinguishes schemazia distortion from anosognosia.
Discriminate · Schizoid Personality Disorder vs Depersonalisation open
Schizoid Personality Disorder · Depersonalisation
A person describes feeling emotionally cut off from others. Before revealing the answer, decide what distinguishes schizoid personality disorder from depersonalisation.
Discriminate · Schizophasia vs Aphasia open
Schizophasia · Aphasia
A patient's speech is severely disorganised and hard to follow. Before revealing the answer, decide what distinguishes schizophasia from aphasia.
Discriminate · Schizotypal Personality Disorder vs Schizoid Personality Disorder open
Schizotypal Personality Disorder · Schizoid Personality Disorder
A patient shows a longstanding pattern of social withdrawal and detachment. Before revealing the answer, decide what distinguishes schizotypal personality disorder from schizoid personality disorder.
Discriminate · Screen Memory vs False Memory open
Screen Memory · False Memory
A patient's memory of a past event turns out, on closer examination, not to be entirely accurate. Before revealing the answer, decide what single question distinguishes a screen memory from a false memory.
Discriminate · Sense of Presence vs Hallucination open
Sense of Presence · Hallucination
A patient describes feeling that someone else is nearby. Before revealing the answer, decide what distinguishes a sense of presence from a hallucination.
Discriminate · Sensory Intensity Distortion vs Illusion open
Sensory Intensity Distortion · Illusion
A patient reports a real stimulus is being perceived abnormally. Before revealing the answer, decide what distinguishes sensory intensity distortion from an illusion.
Discriminate · Smiling Depression vs La Belle Indifférence open
Smiling Depression · La Belle Indifférence
A patient's outward presentation seems out of keeping with an underlying problem. Before revealing the answer, decide what distinguishes smiling depression from la belle indifférence.
Discriminate · Somatisation vs Denial open
Somatisation · Denial
A patient with an underlying mood disturbance presents primarily with physical complaints. Before revealing the answer, decide what distinguishes somatisation from denial.
Discriminate · Somatoparaphrenia vs Anosognosia open
Somatoparaphrenia · Anosognosia
A patient with left-sided paralysis after a right hemisphere stroke says something odd about their affected limb. Before revealing the answer, decide what distinguishes somatoparaphrenia from anosognosia.
Discriminate · Stammering and Stuttering vs Mutism open
Stammering and Stuttering · Mutism
A patient's speech is markedly disrupted. Before revealing the answer, decide what distinguishes stammering (stuttering) from mutism.
Discriminate · Stereotyped Posture vs Perseveration of Posture open
Stereotyped Posture · Perseveration of Posture
A patient maintains an unusual posture for an extended period. Before revealing the answer, decide what distinguishes a stereotyped posture from perseveration of posture.
Discriminate · Stiffening of Affect vs Blunting of Affect open
Stiffening of Affect · Blunting of Affect
A patient's emotional display appears unusually resistant to change. Before revealing the answer, decide what distinguishes stiffening of affect from blunting of affect.
Discriminate · Stupor vs Akinetic Mutism open
Stupor · Akinetic Mutism
A patient is immobile and mute, with no reaction to external stimuli. Before revealing the answer, decide what distinguishes psychiatric stupor from akinetic mutism.
Discriminate · Synaesthesia vs Hallucination open
Synaesthesia · Hallucination
A person describes an unusual cross-sensory experience. Before revealing the answer, decide what distinguishes synaesthesia from a hallucination.
Discriminate · Tactile Hallucination vs Visceral Hallucination open
Tactile Hallucination · Visceral Hallucination
A patient describes a sensation of something moving deep inside his chest, distinct from his heartbeat, rather than on the surface of his skin. Is this a tactile hallucination?
Discriminate · Talking Past the Point (Vorbeireden) vs Formal Thought Disorder open
Talking Past the Point (Vorbeireden) · Formal Thought Disorder
A patient's answers to direct questions are consistently incorrect in an unusual way. Before revealing the answer, decide what distinguishes talking past the point from a formal thought disorder.
Discriminate · Tardive Dyskinesia vs Acute Dystonia open
Tardive Dyskinesia · Acute Dystonia
A patient on antipsychotic medication develops an abnormal involuntary movement. Before revealing the answer, decide what distinguishes tardive dyskinesia from acute dystonia.
Discriminate · Thought Alienation vs Obsession open
Thought Alienation · Obsession
A patient describes an unwanted thought. Before revealing the answer, decide what distinguishes thought alienation from an obsession.
Discriminate · Thought Blocking vs Thought Withdrawal open
Thought Blocking · Thought Withdrawal
A patient stops speaking abruptly mid-sentence and cannot say what they were about to say. Before revealing the answer, decide: what single question would tell you whether this is thought blocking or thought withdrawal?
Discriminate · Thought Broadcasting vs Thought Insertion open
Thought Broadcasting · Thought Insertion
A patient reports a disturbance affecting the privacy or ownership of his own thoughts. Before revealing the answer, decide what distinguishes thought broadcasting from thought insertion.
Discriminate · Thought Echo vs Thought Broadcasting open
Thought Echo · Thought Broadcasting
A patient reports a disturbance in which her private thoughts are somehow no longer entirely her own affair. Before revealing the answer, decide what distinguishes thought echo from thought broadcasting.
Discriminate · Thought Insertion vs Thought Broadcasting open
Thought Insertion · Thought Broadcasting
A patient describes an unsettling change in the privacy of his thoughts, but you are not yet sure whether this is thought insertion or thought broadcasting. Before revealing the answer, decide what single question separates the two.
Discriminate · Thought Withdrawal vs Thought Insertion open
Thought Withdrawal · Thought Insertion
A patient describes a disturbance affecting the contents of his own mind, attributed to an outside force. Before revealing the answer, decide what distinguishes thought withdrawal from thought insertion.
Discriminate · Distortion of the Experience of Time vs Disorientation open
Distortion of the Experience of Time · Disorientation
One patient in a severe depressive episode describes each hour feeling as though it drags on endlessly, yet when asked directly she correctly states the date, the day of the week, and her current location. A second patient, acutely unwell following a urinary infection, cannot say what day it is, believes he is still at home rather than in hospital, and is unsure how long he has been unwell. Are both of these best understood as a distortion of the experience of time?
Discriminate · Trailing Phenomena vs Visual Hallucination open
Trailing Phenomena · Visual Hallucination
A patient describes an unusual visual experience involving a moving object. Before revealing the answer, decide what distinguishes trailing phenomena from a visual hallucination.
Discriminate · Transitory Thinking vs Drivelling Thinking open
Transitory Thinking · Drivelling Thinking
A patient's individual thoughts and sentences seem to lose their constancy mid-course. Before revealing the answer, decide what distinguishes transitory thinking from drivelling thinking.
Discriminate · Twilight State vs Restriction of Consciousness open
Twilight State · Restriction of Consciousness
A patient has had an episode of narrowed awareness with relatively organised behaviour. Before revealing the answer, decide what distinguishes a twilight state from restriction of consciousness more broadly.
Discriminate · Undirected Fantasy Thinking vs Delusion open
Undirected Fantasy Thinking · Delusion
A patient describes unrealistic thought content. Before revealing the answer, decide what distinguishes undirected fantasy thinking from a delusion.
Discriminate · Verbal Stereotypy vs Perseveration open
Verbal Stereotypy · Perseveration
A patient's speech contains repeated content that does not fit the current question. Before revealing the answer, decide what distinguishes verbal stereotypy from perseveration.
Discriminate · Verbigeration vs Perseveration open
Verbigeration · Perseveration
A patient repeats the same verbal content over and over. Before revealing the answer, decide what distinguishes verbigeration from perseveration.
Discriminate · Visual Asymbolia vs Agnostic Alexia open
Visual Asymbolia · Agnostic Alexia
A patient cannot read written words despite intact vision. Before revealing the answer, decide what distinguishes visual asymbolia from agnostic alexia.
Discriminate · Visual Hallucination vs Pseudohallucination open
Visual Hallucination · Pseudohallucination
A patient reports seeing something not actually present. Before revealing the answer, decide what distinguishes a visual hallucination from a visual pseudohallucination.