Examkin

Question

Difficulty: MediumSchizophrenia and Psychotic Disorders

A 25-year-old man is brought to the psychiatry clinic by his brother. The brother reports that for the past 3 months, the patient has been barricading himself in his apartment because he believes federal agents are monitoring his thoughts. During the interview, the patient maintains poor eye contact, speaks with a flat affect, and occasionally turns his head to whisper to seemingly empty space, stating that he is answering "the voices." The brother notes that the patient was functioning well and working as a software engineer until 3 months ago when these symptoms abruptly began. The patient has had no periods of depressed mood, increased energy, or decreased need for sleep. Medical workup and urine toxicology screening are unremarkable. Which of the following is the most likely diagnosis?

  1. A
    Schizophrenia
  2. B
    Brief psychotic disorder
  3. Schizophreniform disorderAnswer
  4. D
    Delusional disorder
  5. E
    Schizoaffective disorder

Answer

Schizophreniform disorder
The correct answer is schizophreniform disorder because the patient meets the criteria for active-phase symptoms of schizophrenia (delusions, auditory hallucinations, and negative symptoms) but the total duration of the illness is between 1 and 6 months (3 months in this case).

Step-by-Step Solution

1
Identify the primary clinical syndrome.
The patient has delusions, auditory hallucinations, and negative symptoms (flat affect, poor eye contact) without major mood symptoms.
This establishes a primary psychotic disorder and rules out mood disorders with psychotic features.
2
Determine the exact duration of the psychotic symptoms.
The brother reports the symptoms have been present for exactly 3 months.
Duration is the primary differentiating factor among the acute psychotic disorders.
3
Apply DSM-5 timeline criteria for psychotic disorders.
Symptoms lasting between 1 and 6 months meet the criteria for schizophreniform disorder.
Brief psychotic disorder is <1 month, and schizophrenia is >6 months.

Key Concept

Psychotic disorders are differentiated by symptom duration: brief psychotic disorder (<1 month), schizophreniform disorder (1 to 6 months), and schizophrenia (>6 months).
Rate this question

Topics

Schizophrenia and Psychotic Disorders

More questions from this topic