DIAGNOSIS CHECKLIST
for Hallucinations

Why: to determine if acute or chronic.

Why: Delirium is an acute confusional state due to many causes e.g. infection, drug intoxication, alcohol withdrawal, liver failure, kidney failure, hypoxia (reduced oxygen levels in the blood), low blood sugar, stroke, heart attack or head injury. If the onset is chronic a diagnosis of psychiatric illness or dementia may be more likely.

Why: this would suggest an organic cause such as delirium, epilepsy or brain tumor.

Why: this is the type of hallucination most commonly associated with schizophrenia but may be associated with bipolar affective disorder, dementia or delirium, and their content tends to be related to the nature of the disorder.

Why: if hallucinations occur in episodes with normal behavior in between, one should consider epilepsy or narcolepsy.

Why: these type of hallucinations are called "hypnogogic" and are common in narcolepsy but may also be seen in normal people.

Why: e.g. hallucinations and other symptoms that are worse in the late afternoon and at night are typical of delirium.

Why: e.g. physical illness, recent surgery, starting a different medication, abstaining from alcohol.

Why: e.g. schizophrenia, bipolar affective disorder, paranoid disorder, schizotypal personality disorder, schizoid personality disorder- may be sometimes difficult to differentiate between delirium and these disorders if delusions and hallucinations are present.

Why: certain medications may cause intoxication e.g. anticonvulsants, anticholinergics, antihistamines, antidepressants, anti-anxiety medications, opiates; or may cause delirium on drug withdrawal.

Why: e.g. high blood pressure, high cholesterol, diabetes, smoking, family history.

Why: e.g. Alzheimer's disease, Huntington's disease, multiple sclerosis, stroke, heart attack, schizophrenia, bipolar affective disorder and depression, lupus erythematosus, epilepsy.

Why: to assess chance of alcohol withdrawal, delirium tremens, alcohol abuse, alcohol poisoning, Korsakoff's psychosis as the cause of hallucinations. Hallucinations are common during alcohol withdrawal.

Why: amphetamine, marijuana, cocaine, LSD, PCP may cause delirium and may also precipitate acute psychosis.

Why: may be present in schizophrenia, bipolar affective disorder, psychotic depression, paranoid delusional disorder, paranoid personality disorder, schizotypal personality disorder, brain damage, abuse of stimulant of hallucinogenic drugs, dementia and cultural isolation.

Why: e.g. impaired memory, impaired judgement and thinking, impaired verbal fluency and impaired ability to perform complex tasks. Personality may change, impulse control may be lost and personal care deteriorates. People with dementia may also have psychiatric symptoms such as delusions, paranoid ideas, hallucinations, mood disturbance and behavioral disturbance.

Why: e.g. impaired conscious level with onset over hours or days, disorientation in time and/or place, unusually quite, drowsy, agitated, delusions, auditory hallucinations, visual hallucinations.

Why: can suggest any infection that may cause delirium or meningitis, encephalitis, brain abscess or brain hemorrhage.

Why: e.g. delusions, hallucinations and disordered thinking - may suggest schizophrenia or bipolar disorder but these symptoms may also be present with delirium, dementia and severe depression.

Why: may suggest brain cancer, acute stroke or migraine.