Examkin

Question

Difficulty: MediumSchizophrenia and Psychotic Disorders

Match each patient's clinical presentation to the most appropriate psychiatric diagnosis.

  • A 22-year-old man is evaluated for severe agitation and disorganized speech that began 2 weeks ago. He is convinced his professors have placed hidden cameras in his room. He has no prior psychiatric history.Brief Psychotic Disorder
  • A 29-year-old woman is evaluated for continuous auditory hallucinations and profound avolition. Her symptoms began 4 months ago. She has no history of major depressive or manic episodes.Schizophreniform Disorder
  • A 24-year-old man presents with a 1-year history of worsening social withdrawal, flattened affect, and persecutory delusions. His academic performance has significantly declined over this period.Schizophrenia
  • A 35-year-old woman firmly believes a famous actor is secretly in love with her. She has maintained this belief for 6 months. She continues to work successfully as an attorney and has no hallucinations or disorganized behavior.Delusional Disorder
  • A 27-year-old man with a 3-year history of recurrent major depressive episodes has experienced persistent auditory hallucinations for the past year. Notably, he had a 4-week period where his mood was completely normal, but the hallucinations continued.Schizoaffective Disorder

Answer

1 matches with Brief Psychotic Disorder; 2 matches with Schizophreniform Disorder; 3 matches with Schizophrenia; 4 matches with Delusional Disorder; 5 matches with Schizoaffective Disorder.
Each diagnosis is firmly established by careful evaluation of symptom duration, presence of concurrent mood episodes, and overall functional impairment as outlined in the DSM-5 criteria.

Step-by-Step Solution

1
Analyze the duration of psychotic symptoms for each patient.
Patient 1: 2 weeks; Patient 2: 4 months; Patient 3: 1 year.
Total duration of illness is the primary differentiator among Brief Psychotic Disorder (<1 month), Schizophreniform Disorder (1-6 months), and Schizophrenia (>6 months).
2
Evaluate the presence of mood episodes and their temporal relationship to psychotic symptoms.
Patient 5 has recurrent major depressive episodes but also a 4-week period of psychosis without mood symptoms.
Documenting psychotic symptoms for more than 2 weeks in the absence of mood symptoms distinguishes Schizoaffective Disorder from a Major Depressive Disorder with psychotic features.
3
Assess the nature of the delusion and the patient's level of functioning.
Patient 4 has an isolated erotomanic delusion for 6 months without other psychotic symptoms and with preserved occupational functioning.
Isolated delusions with a lack of significant overall functional impairment define Delusional Disorder.

Key Concept

The differential diagnosis of primary psychotic disorders relies heavily on the exact timeline of symptoms, overall functional decline, and the relationship between psychotic and mood episodes.
Estimated Time:1m 30s
Rate this question

Topics

Schizophrenia and Psychotic Disorders

More questions from this topic