Psychoses 01
Topic: Anatomy
Created on Friday, December 29 2006 by
Last modified on Friday, December 29 2006.
A 27 year-old male yam cleaner is brought by ambulance to the emergency room.
He is uncooperative, disheveled, and insists that the Illuminati is trying to kill him.
He complains of hearing voices telling him to feed the horses.
He is accompanied by his son, who states that he was lucid and rational until 9 days ago. He has been exhibiting these behaviors fairly consistently since that time.
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) Psychotic disorder due to a general medical condition D) Schizophrenia E) Brief psychotic disorder
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 does not present with mood symptoms. (
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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. (
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C) psychotic disorder due to a general medical condition
This answer is incorrect.
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. His psychosis has no obvious organic cause. (
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D) schizophrenia
This answer is incorrect.
The diagnosis of schizophrenia requires at least 6 months of continuous signs of psychological disturbance. This 6-month period must include at least 1 month of "active-phase" symptoms: delusions, halucinations, disorganized speech, grossly disorganized or catatonic behavior, or negative symptoms (affective flattening, alogia, or avolition). This patient's symptoms have lasted less than a total of 1 month. (
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E) brief psychotic disorder
This answer is correct.
The diagnosis of brief psychotic disorder is made when a patient has delusions, hallucinations, disorganized speech, or grossly disorganized behavior (not attributable to a substance or general medical condition) for more than 1 day but for less than 1 month. This patient is displaying psychotic symptoms of delusions and hallucinations. His psychosis has no obvious organic cause. He has been psychotic for less than 1 month. (
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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