Question

A young woman comes to the emergency room with a 1-week history of pressured speech, decreased sleep, grandiosity, and loosening of associations. The patient feels that she is being monitored by a satellite and she is seen talking to herself when no one else is in the room. Which one of the following criteria must be met to diagnose this patient with schizoaffective disorder instead of bipolar disorder?

A. Presence of mania
B. Psychotic symptoms in the absence of mood symptoms for a 1-week period
C. At least one prior episode of depression
D. Presence of psychotic symptoms during a manic episode
E. Psychotic symptoms in the absence of mood symptoms for a 2-week period

Answer 1

To diagnose schizoaffective disorder instead of bipolar disorder, the presence of psychotic symptoms without concurrent mood symptoms for at least 2 weeks is required.

Step-by-step explanation:

Diagnosis Criteria for Schizoaffective Disorder vs. Bipolar Disorder

To diagnose a patient with schizoaffective disorder instead of bipolar disorder, it is required that the patient has psychotic symptoms in the absence of mood symptoms for at least a 2-week period. This criterion differentiates schizoaffective disorder from bipolar disorder, where psychotic symptoms are typically present only during episodes of mood disturbance such as mania or depression. The patient described in the question exhibits pressured speech, decreased sleep, grandiosity, and loosening of associations, which are indicative of a manic episode, and also delusions and possibly hallucinations. However, without evidence of psychotic symptoms occurring outside the mood episodes, it would be more appropriate to consider a diagnosis of bipolar disorder with psychotic features.