This month we turn to psychiatric topics, beginning with an important clinical question: when a child or adolescent presents with unusual thoughts, perceptions, or behaviors, how do we distinguish psychosis from other psychiatric or medical conditions? In this episode, our host Paul Wirkus, MD and guest Kristi Kleinschmit, MD discuss psychotic experiences and how they can occur in conditions including major depression, bipolar disorder, and OCD, as well as with substance use and trauma or PTSD. We explore how to think about experiences such as imaginary friends and vivid imagination, and when symptoms such as catatonia should prompt a closer evaluation. The conversation also emphasizes the importance of looking beyond a psychiatric diagnosis. Infection, other medical illnesses, and genetic syndromes can all play a role in changes in behavior or perception, making a thoughtful history and appropriate medical evaluation essential. The episode offers pediatricians a framework for recognizing concerning symptoms, considering the broader differential diagnosis, and determining when additional evaluation or referral is needed. Have a question for our hosts or guests? Email questions@vcurb.com. For more information, additional episodes, and available CME/MOC credit, visit vcurb.com. The Virtual Curbside is a podcast of the American Academy of Pediatrics, Utah Chapter (UTAAP), connecting pediatricians and subspecialists through practical, accessible pediatric education. Learn more about UTAAP at aaputah.org. ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.