Psychoses 01

Topic: Anatomy

Created on Friday, December 29 2006 by

Last modified on Friday, December 29 2006.

A 36 year-old male lawyer is brought by ambulance to the emergency room.
He is uncooperative, disheveled, and insists that the LAPD is trying to kill him.
He complains of hearing voices telling him that he is worthless and weak.
He is accompanied by his nephew, who states that he was lucid and rational until 4 hours ago, when he ingested "like, 22 pounds of marijuana."
Apart from his mental status, physical exam is unremarkable.

Of the following, which is the most appropriate diagnosis?

A) Schizoaffective disorder

B) Substance-induced psychotic disorder

C) Schizophreniform disorder

D) Psychotic disorder due to a general medical condition

E) Delusional 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) 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. (See References)


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B) substance-induced psychotic disorder

This answer is correct.

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. This patient has had sinificant exposure to substances with hallucinogenic effects, which can explain the psychotic symptoms. (See References)


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C) 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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D) 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. Apart from drug use, this patient has no known medical condition that would cause pyschosis. (See References)


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E) 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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References:

1. American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision. American Pyschiatric Association, Washington, DC. (ISBN:0890420254)

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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