In this work we introduce new approximate similarity relations that are shown to be key for policy (or control) synthesis over general Markov decision processes. The models of interest are discrete-time Markov decision processes, endowed with uncountably-infinite state spaces and metric output (or observation) spaces. The new relations, underpinned by the use of metrics, allow in particular for a useful trade-off between deviations over probability distributions on states, and distances between model outputs. We show that the new probabilistic similarity relations, inspired by a notion of simulation developed for finite-state models, can be effectively employed over general Markov decision processes for verification purposes, and specifically for control refinement from abstract models.