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Zorluk: OrtaSchizophrenia and Psychotic Disorders

A 20-year-old male college student is brought to the student health center by his parents due to concerning behavior. His parents report that he has become increasingly socially isolated over the past eight months. During this time, he quit the university soccer team, stopped communicating with his friends, and his academic performance dropped significantly. He spends most of his days in his room with the blinds drawn and displays a distinct lack of emotional expression. For the last six weeks, the patient has firmly believed that the university administration is using the campus wireless network to monitor his thoughts. His parents have also observed him talking animatedly to himself when alone in his room. Vital signs and physical examination are unremarkable. A urine toxicology screen is negative. Which of the following is the most likely diagnosis?

  1. SchizophreniaCevap
  2. B
    Schizophreniform disorder
  3. C
    Brief psychotic disorder
  4. D
    Schizoaffective disorder
  5. E
    Major depressive disorder with psychotic features

Cevap

Schizophrenia
The correct answer is Schizophrenia. The diagnosis of schizophrenia requires the presence of active-phase symptoms (such as delusions and hallucinations) for at least 1 month, along with continuous signs of the disturbance (which can include prodromal negative symptoms) lasting for at least 6 months. This patient has a 9.5-month total history of disturbance (8 months of prodromal social isolation and affective flattening followed by 6 weeks of active psychosis), which meets the temporal criteria for schizophrenia.

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1
Identify the patient's active psychotic symptoms and their duration.
The patient has delusions (monitored by Wi-Fi) and hallucinations (talking to himself in an empty room) lasting for 6 weeks.
Establishing the presence and duration of active-phase symptoms is required for the Criterion A of psychotic disorders.
2
Identify any prodromal or residual symptoms and calculate the total duration of the illness.
The patient had an 8-month prodromal phase characterized by negative symptoms (social isolation, flattened affect, anhedonia). The total duration of the disturbance is 8 months + 6 weeks = 9.5 months.
The total duration of the disturbance (prodrome + active phase + residual phase) distinguishes between brief psychotic disorder, schizophreniform disorder, and schizophrenia.
3
Match the total duration to the corresponding diagnostic criteria.
A total duration greater than 6 months corresponds to schizophrenia.
Brief psychotic disorder is <1 month, schizophreniform disorder is 1-6 months, and schizophrenia is >6 months.

Anahtar Kavram

The diagnosis of schizophrenia requires at least 1 month of active-phase symptoms and continuous signs of the disturbance (including prodromal symptoms) persisting for at least 6 months.
Tahmini Süre:1m 15s
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Schizophrenia and Psychotic Disorders

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