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Zorluk: KolaySchizophrenia and Psychotic Disorders

An agitated 35-year-old woman presents to the psychiatric triage center accompanied by her sister. The patient is visibly distressed and states that her neighbors are broadcasting her thoughts over the internet. According to her sister, these symptoms began suddenly 14 days ago, shortly after the patient unexpectedly lost her job. The patient is also experiencing auditory hallucinations. She has no prior history of mental illness, takes no medications, and her urine drug screen is negative. Which of the following is the most likely diagnosis?

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

Cevap

Brief psychotic disorder
The correct answer is brief psychotic disorder because the patient presents with positive psychotic symptoms (delusions and auditory hallucinations) that have been present for 14 days. According to diagnostic criteria, psychotic symptoms lasting between 1 day and 1 month, followed by an expected full return to premorbid functioning, confirm this diagnosis. The recent job loss also serves as a classic acute stressor often associated with this condition.

Adım Adım Çözüm

1
Identify the primary clinical symptoms presented in the vignette.
The patient has delusions (neighbors broadcasting her thoughts) and auditory hallucinations.
Establishing the presence of positive psychotic symptoms is the first step in diagnosing a psychotic disorder.
2
Determine the exact duration of the psychotic symptoms.
The sister reports the symptoms began abruptly 14 days ago.
Symptom duration is the key distinguishing factor among the primary psychotic disorders.
3
Assess for concurrent medical conditions, substance use, or mood episodes.
Drug screen is negative, no medications are taken, and no mood symptoms (like severe depression or mania) are reported.
This rules out substance-induced psychosis and schizoaffective disorder.
4
Match the symptom profile and timeline to the correct diagnostic criteria.
Symptoms lasting more than 1 day but less than 1 month point exclusively to brief psychotic disorder.
Brief psychotic disorder is diagnosed when symptoms resolve within 1 month. Schizophreniform is 1-6 months, and schizophrenia is >6 months.

Anahtar Kavram

The primary differentiation between brief psychotic disorder, schizophreniform disorder, and schizophrenia is based on the duration of symptoms.
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Konular

Schizophrenia and Psychotic Disorders

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