Psychoses 01
Topic: Anatomy
Created on Friday, December 29 2006 by
Last modified on Friday, December 29 2006.
A 20 year-old male malpractice attorney is brought by ambulance to the emergency room.
He is uncooperative, disheveled, and insists that he is the Supreme Overlord of the antelope people.
He complains of hearing voices telling him that he is worthless and weak.
He is accompanied by his son, who states that he was lucid and rational until 4 days ago, when he also began to complain of nausea and headache.
Physical exam is significant for opisthotonus, jolt accentuation of headache, nuchal rigidity, and high fever.
Of the following, which is the most appropriate diagnosis?
A) Delusional disorder B) Schizophreniform disorder C) Schizoaffective disorder D) Psychotic disorder due to a general medical condition E) Mood disorder with psychotic features
This question was created on December 29, 2006 by .
This question was last modified on December 29, 2006.
ANSWERS AND EXPLANATIONS
A) 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 psychosis has an obvious organic cause. (
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B) 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's psychosis has an obvious organic cause. (
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C) schizoaffective disorder
This answer is incorrect.
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's psychosis has an obvious organic cause. (
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D) psychotic disorder due to a general medical condition
This answer is correct.
The diagnosis of psychotic disorder due to a general medical condition is made when findings of delusions, hallucinations, disorganized speech, or grossly disorganized behavior are attributable to the direct physiological effects of a general medical condition. This patient has exam findings suggestive of meningitis, which can explain the psychotic symptoms. (
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E) 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 has an obvious organic cause. (
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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:
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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