Question

Mr. A is a 22 year old law student living alone in the dorms. Over the last 8 months, his academic performance has declined and he is being considered for academic probation. He has become isolated and withdrawn and the girl he was dating recently broke up with him. He believes she has been replaced by a look-alike from a distant planet and his fellow students are conspiring against him. He believes they snort and sneeze whenever her enters the class. He reports getting distracting signals from the TV and he hears voices of the devil calling to him. He called his father and asked for help and his father brought him to the psychiatric hospital for evaluation. Physical exam was normal, including CT scan and negative urine toxicology.

What is the most likely diagnosis?
A. Brief psychotic disorder (no, because brief psychotic disorder is an acute psychotic disorder that lasts from one day to one month and develops in response to a severe psychosocial stressor or group of stressors)
B. Schizophreniform (no, symptoms last at least one month but less than six months)
C. Delusional disorder (no, nonbizarre delusions present for at least one month without other symptoms of schizophrenia or a mood disorder)
D. Schizophrenia, paranoid type (yes, the presence of delusions or hallucinations are not necessary for a diagnosis of schizophrenia; but rather, two or more of the following: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behvior, or negative symptoms. Must last for at least six months)

Answer 1

The condition of Mr A can be referred to as Schizophrenia, paranoid type as shown by his symptoms so the correct option is D. Schizophrenia, paranoid type

Step-by-step explanation:

Mr. A's symptoms, including delusions of conspiracy, hallucinations, and impaired social functioning lasting over 8 months, are indicative of schizophrenia.

The paranoid type is characterized by prominent delusions, such as the belief that others are plotting against the individual. While hallucinations are not necessary for a schizophrenia diagnosis, Mr. A's reported auditory hallucinations further support this classification.

The absence of mood disorder symptoms rules out schizoaffective disorder, and the persistence and nature of symptoms distinguish schizophrenia from brief psychotic disorder or schizophreniform disorder. The negative physical exam findings and lack of response to psychosocial stressors make an organic cause less likely.

Thus, the most fitting diagnosis is schizophrenia, paranoid type, as it encompasses Mr. A's multifaceted psychotic manifestations lasting beyond the required six-month duration.

The condition of Mr A can be referred to as Schizophrenia, paranoid type as shown by his symptoms so the correct option is D. Schizophrenia, paranoid type