The FrontalCortex question bank can help you study for the neurology boards.

Psychoses 01

Topic: Anatomy

Created on Friday, December 29 2006 by

Last modified on Friday, December 29 2006.

A 31 year-old male halibut wrangler is brought by ambulance to the emergency room.
He is uncooperative, disheveled, and insists that an evil locust is trying to kill him.
He complains of hearing voices telling him that he is worthless and weak. He states that he hates his life and wants to kill himself.
He is accompanied by his sister, who states that he was lucid and rational until 6 months ago. He has been exhibiting these behaviors off and on since that time. The sister states that the patient is not always depressed when he is hearing voices telling him that he is worthless and weak.
There is no significant past medical or psychiatric history.
Apart from his mental status, physical exam is unremarkable.
Urine and serum toxicology screens are negative. Other lab work and imaging, including head CT and MRI, are normal.

Of the following, which is the most appropriate diagnosis?

 
        A) Mood disorder with psychotic features
 
        B) Substance-induced psychotic disorder
 
        C) Schizoaffective disorder
 
        D) Delusional disorder
 
        E) Schizophreniform disorder
 

 


Back to the question = Go back to the top of the page.
See another question like this one = Reload a different version of this question ().
Click here for a random question = Load a random question from the database.
Clone this question = Use this question as a template to create a totally NEW question.
Rate this question = Enter detailed rating for this question!
Average user rating for this question = 4.5 = How users like you have rated this question.
This question was created on December 29, 2006 by .
This question was last modified on December 29, 2006.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) mood disorder with psychotic features

This answer is incorrect.


Like schizoaffective disorder, the diagnosis of mood disorder with psychotic features requires both psychotic and mood symptoms. However, in mood disorder with psychotic features, the psychotic features are never present without the mood symptoms. When patient mood normalizes, the psychotic features resolve. This patient's psychosis is not always present at the same time as the mood symptoms.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4.5
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




B) substance-induced psychotic disorder

This answer is incorrect.


The diagnosis of substance-induced psychotic disorder is made when findings of delusions, hallucinations, disorganized speech, or grossly disorganized behavior are attributable to the direct physiological effects of a medication, drug of abuse, toxin, or other substance. His psychosis has no obvious organic cause.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4.5
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




C) schizoaffective disorder

This answer is correct.


Schizoaffective disorder is a manifestation of both psychotic symptoms and mood disorder. The diagnosis requires a period of at least 2 weeks during which the patient suffers from hallucinations or delusions in the absence of prominent mood symptoms. This patient is displaying psychotic symptoms of delusions and hallucinations, but also has symptoms of a major depressive disorer. His psychosis has no obvious organic cause. He has been psychotic for more than 1 month. The psychosis does not always coincide with the depression.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4.5
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




D) delusional disorder

This answer is incorrect.


In delusional disorder, the patient is delusional for at least 1 month, but has no other marked impariment of function. This patient's psychotic features are not limited to delusions. He is also hallucinating, and by history is functionally impaired.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4.5
Please log in if you want to rate questions.

 

 

 

 

 

 

 

 

 




E) schizophreniform disorder

This answer is incorrect.


The diagnosis of schizophreniform disorder is made when psychotic symptoms last more than 1 month, but less than 6 months. After 6 months, a diagnosis of schizophrenia can be made. Prior to 1 month, a diagnosis of brief psychotic disorder should be considered. This patient is psychotic, but he also has symptoms of a mood disturbance.  (See References)

Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4.5
Please log in if you want to rate questions.

 

 

 

 

References:

1. American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision. American Pyschiatric Association, Washington, DC. (ISBN:0890420254)Advertising:
Back to the questionSee another question like this oneClick here for a random questionClone this question Rate this questionAverage user rating for this question = 4.5
Please log in if you want to rate questions.

 

FrontalCortex.com -- Neurology Review Questions -- Neurology Boards -- Board Review -- Residency Inservice Training Exam -- RITE Exam Review
anatomy
Psychoses 01
Question ID: 12290600
Question written by . (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 12/29/2006
Modified: 12/29/2006
Estimated Permutations: 0

User Comments About This Question:

0 user entries
Please log in if you'd like to add a comment.