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Psychoses 01

Topic: Anatomy

Created on Friday, December 29 2006 by

Last modified on Friday, December 29 2006.

A 24 year-old male beet salesperson is brought by ambulance to the emergency room.
He is uncooperative, disheveled, and insists that a neighborhood sea urchin is putting thoughts into his head.
He complains of hearing voices telling him to feed the vipers.
He is accompanied by his sister, who states that he was lucid and rational until 2 days ago, when he also began to complain of nausea and headache.
Physical exam is significant for positive Brudzinski sign, repeated vomiting, nuchal rigidity, and high fever.

Of the following, which is the most appropriate diagnosis?

 
        A) Delusional disorder
 
        B) Schizophrenia
 
        C) Psychotic disorder NOS
 
        D) Psychotic disorder due to a general medical condition
 
        E) Schizophreniform disorder
 

 


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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.  (See References)

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B) 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 psychosis has an obvious organic cause.  (See References)

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C) psychotic disorder NOS

This answer is incorrect.


Psychotic disorder NOS is only made when a patient is psychotic, but does not meet the criteria for another diagnosis. This patient's psychosis has an obvious organic cause.  (See References)

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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.  (See References)

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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's psychosis has an obvious organic cause.  (See References)

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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
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