Examkin

Question

Difficulty: MediumSchizophrenia and Psychotic Disorders

Match each clinical presentation with the most likely definitive psychiatric diagnosis.

  • A 27-year-old woman exhibits auditory hallucinations and disorganized speech for 2 weeks following a severe psychological stressor, followed by a full return to her premorbid level of functioning.Brief psychotic disorder
  • A 22-year-old man presents with a 4-month history of worsening social withdrawal, avolition, and persistent delusions of reference regarding television broadcasts.Schizophreniform disorder
  • A 31-year-old man with a 2-year history of prominent auditory hallucinations develops an episode of major depression. His psychotic symptoms persist even during periods of normal mood.Schizoaffective disorder
  • A 45-year-old woman has firmly believed for the past year that her neighbor is plotting to sabotage her garden. She functions normally at her job and has no disorganized behavior or hallucinations.Delusional disorder

Answer

The correct matches are based on symptom duration and the relationship between mood and psychotic symptoms: Brief psychotic disorder (<1 month), Schizophreniform disorder (1-6 months), Schizoaffective disorder (psychosis independent of mood episodes), and Delusional disorder (isolated delusions).
Each psychiatric diagnosis is defined by specific temporal and symptomatic criteria as established in the DSM-5. Brief psychotic disorder is characterized by symptoms lasting less than 1 month with full recovery. Schizophreniform disorder requires symptoms lasting between 1 and 6 months. Schizoaffective disorder requires a major mood episode concurrent with active-phase psychotic symptoms, plus a distinct period of at least 2 weeks of delusions or hallucinations without prominent mood symptoms. Delusional disorder involves at least 1 month of delusions without meeting criteria for schizophrenia, and functioning is not markedly impaired.

Step-by-Step Solution

1
Evaluate the duration of psychotic symptoms for each patient.
The patients have symptoms lasting 2 weeks, 4 months, 2 years, and 1 year, respectively.
Duration is the primary diagnostic differentiator for brief psychotic disorder (<1 month), schizophreniform disorder (1-6 months), and schizophrenia (>6 months).
2
Assess the temporal relationship between mood symptoms and psychosis.
The patient with a 2-year history of hallucinations maintains these symptoms even when not depressed.
Psychosis occurring for >2 weeks without concurrent mood symptoms rules out a major mood disorder with psychotic features, confirming schizoaffective disorder.
3
Determine the breadth of symptoms and level of functional impairment.
The 45-year-old woman has an isolated false belief without negative symptoms or global dysfunction.
Isolated delusions without other psychotic features or marked functional decline are the hallmark of delusional disorder.

Key Concept

Differentiating primary psychotic disorders based on symptom duration, symptom cluster, and the temporal relationship between mood episodes and psychosis.
Rate this question

Topics

Schizophrenia and Psychotic Disorders

More questions from this topic