A 49-year-old man with a known history of alcohol dependence and schizophrenia is brought to the psychiatric hospital because of frank delusions and visual hallucinations. Which of the following should be a diagnostic possibility for inclusion in the differential diagnosis?

Choice A reason: Borderline personality disorder may involve transient psychotic symptoms under stress, but it does not typically present with sustained delusions and visual hallucinations. It is not a primary differential diagnosis in this context. Choice B reason: Steroid-induced psychosis is a valid diagnosis but requires a history of corticosteroid use. There is no mention of steroid exposure in this case, making it less likely. Choice C reason: Brief psychotic disorder involves sudden onset of psychotic symptoms lasting less than one month, often triggered by stress. Given the patient’s chronic psychiatric and substance use history, this diagnosis is less appropriate. Choice D reason: Substance/medication-induced psychotic disorder is highly relevant in this case. Alcohol dependence can lead to psychotic symptoms, especially during withdrawal or intoxication. This diagnosis accounts for both substance use and the presence of hallucinations and delusions.