1. Drew Chenelly, Psy.D.
Avallon Behavioral Health, LLP
Differential Diagnosis
DELIRIUM DEMENTIA DEPRESSION
Onset Sudden Insidious Depressive Sx’s
appear before
cognitive
impairment
Course duration Rapid fluctuation
Diurnal
Month or less
Progressive
Downward or
stable
Lifelong
Stable with
fluctuation
Diurnal
Months
Level of
consciousness
Clouded with
lucid intervals
Clear Clear
Attention Greatly reduced
or heightened
Normal Slightly reduced
Psychomotor
activity
Increased or
decreased
Normal Decreased
Visual
hallucinations or
illusions
Yes No No
Memory Global
impairment
Fluctuates
Recent impaired
Remote intact
Normal
Orientation At times total
impairment
Partial impairment Normal
Abstract
thinking/
judgment
Impaired Impaired Normal
Thinking Irrelevant,
incoherent
speech
Loss of higher
cortical functions:
aphasias/agnosias/
apraxias
Slowed
Sleep/wake cycle Reversed Reduced Sleep EMA
Appearance Dazed or fearful
expression
Apathetic,
indifferent, poor
hygiene
Sad, slow,
worried
Presentation of
Sx’s.
Sx’s dramatic
No insight
Denies or conceals
Cognitive deficits
c/o Memory
impairment &
poorintellectual
performance
