Describe how the new information alters the picture presented in the original case study. Before posting, you might want to review Ben Part 1, the case you discussed last week (u06d2).
This new information concerning Ben has now provided evidence for some kind of psychotic episode. His behavior is uncharacteristic for him. His past history and family history bring up more cause for concern. With his medical records concerning his prior auto accident, physical damage is no longer a primary concern.
Describe your new diagnostic hypotheses, and justify your conclusions.
The clinician would have to rule out Brief Psychotic Disorder, because the previous episode in college lasted for 8 months (APA, 2013). Schizophreniform Disorder would also be ruled out because the episode in College lasted for longer than 6 months (APA, 2013). To meet the criteria for schizophrenia he must meet two of the criteria in category A (APA, 2013). He is clearly delusional, with the comments about his boss, his past behavior with the research paper, but he does not really meet any of the other criteria (APA, 2013). Perhaps he has disorganized speech, but that would need to be evaluated. The conversations we have had with him are brief due to his resistance.
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His function is not markedly impaired. He does seem to be forgetting things, like starting his car, remembering plans, and getting himself organized. He did eat his cereal with his hand. He has irritable and dysphonic moods and displays anger and violent behavior, which is common in persecutory type delusions (APA, 2013). Spontaneous and random assault is not common with schizophrenia unless the person has a violent past (APA, 2013). Ben’s wife states he is not violent. His outburst at the party could be interpreted as a random
In this particular case, Mr. Jock’s symptoms have met criteria for an episode of mania, which is characterized by a period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting for at least 1 week and present most of the day, nearly every day (DSM-5, Criterion A of Manic Episode). During this period, the patient should be significantly experiencing at least three or more symptoms of inflated self-esteem or grandiosity, decreased need for sleep, more talkative than usual or pressure to keep talking, flight of ideas or subjective experience that thoughts are racing, distractibility, increased in goal-directed activity or psychomotor agitation, and/or excessive involvement in activities that have a high potential for painful consequences (DSM-5, Criterion B of Manic Episode).
My patient Gerald –according to the video- is diagnosed with a textbook case schizophrenia. He exhibits paranoid thinking and his speech is disorganized, his thoughts are loosely connected, and he has formed delusions, he exhibits mood disturbances, and exhibits disordered behaviors (Schizophrenia: Gerald, Part 1). The goal for Gerald is multi-factorial; first, it is important to place into context that Gerald’s schizophrenia is refractory to pharmacological management. Due to Gerald’s complex presentation of multiple symptoms, the goal for the interaction is improved m...
As an experienced psychiatrist, I have dealt with many cases such as this case involving Perry Smith. I have diagnosed personality disorders such as schizophrenia, and I believe that Perry shows several signs of this disorder. My diagnosis comes from the fact that Perry has emotional reactions that are unpredictable and inappropriate, he has disturbed relationships, and he acts withdrawn, always "a loner without any real friends." His inability to communicate with his family is a warning sign of schizophrenia. Poverty and a disorganized family life are often looked at as causes of the disorder; Perry Smith's family was not, by any means, wealthy, and they were unarguably disorganized. Perry Smith has a split personality; he's a schizophrenic.
At the age of twenty Charles’s experienced his first psychotic break. Not knowing what was happening Mother called the police as she believed the hallucinations and delusions were from marijuana and cocaine use. Charles was taken to the local jail and from there to the hospital when the symptoms remained for 12 hrs. At which time Charles was diagnosed with schizophrenia.
According the fourth edition diagnostic manual of mental disorders (American Psychiatric Association, 2000), the category psychotic disorders (Psychosis) include Schizophrenia, paranoid (Delusional), disorganized, catatonic, undifferentiated, residual type. Other clinical types include Schizoaffective Disorder, Bipolar Affective Disorder/Manic depression, mania, Psychotic depression, delusional (paranoid) disorders. These are mental disorders in which the thoughts, affective response or ability to recognize reality, and ability to communicate and relate to others are sufficiently impaired to interfere grossly with the capacity to deal with reality; the classical and general characteristics of psychosis are impaired reality testing, hallucinations, delusions, and illusions. Mostly, these are used as defining features of psychosis even if there are other psychotic symptoms that characterise these disorders (L. Bortolotti, 2009).
Schizophrenia has multiple symptoms; according to the World of Health Organization, these symptoms include “delusions, hallucinations, disorganized speech and behavior [as well as depressive behavior].” Monomania
According to the DSM-5 Diagnostic Criteria for Schizophrenia, a diagnosis requires that two or more positive, negative, and/or disorganised symptoms be present for at least 1 month, with at least one of these symptoms including delusions, hallucinations, or disorganised speech (American Psychiatric Association, 2013). Nathaniel suffers from mild positive symptoms of schizophrenia with paranoia and disorganised behaviours. This is evident in his auditory hallucinations of persecutory nature and delusions of persecution. In addition, positive symptoms typically involve the individual showing unusual behaviors, dressing peculiarly, and displaying disorganised behaviour (Gleitman, Gross & Reisberg, 2011). Nathaniel had odd attires like wearing a reflective vest, he is frenzy, ran haphazardly across roads, ignores personal hygiene, and at times acted violently. He also displays signs of disorganised speech with derailment and incoherence. The diagnosis also requires continuous signs of disturbance to persist for at least 6 months, in which must include at least 1 month of active-phase symptoms (American Psychiatric Association, 2013). Nathaniel’s active-phase symptoms persisted for longer than 6 months, in which would be considered as a chronic
Case introduction: A 19 year-old gentlemen, SS, presented to station 20N through the emergency department, following what was described by friends and family as “bizarre behavior.” SS had recently begun college at a local liberal arts school. He had done well during the first semester, but began to struggle academically during the second semester. Family attributed the decline in academic success to an increase in class size, which made SS uncomfortable. Several weeks prior to hospital admission, SS became increasingly isolated, spending the majority of his time in the dorm room and less time in class. Friends and roommates reported that SS was exhibiting bizarre behavior, often confiding in friends that he was being “spied on” by others and that people around him could “read his thoughts.” SS also endorsed a strange delusion in which those around him would blink simultaneously as a form of communication. All of the aforementioned events became overly distressing to SS and his family, so they sought medical help. SS had a limited psychiatric history for which he had seen a psychiatrist. The psychiatrist had put him on an anti-psychotic medication some months prior, but SS self-discontinued the medication after just a several week trial. As a result of the above, and a lack of explanation regarding the past psychiatric referral, the events were described as “first-episode psychosis.” Discussion regarding the diagnostic work-up followed.
Schizophrenia is a long term psychological effect that has affected him from taking drugs all these years. All these drugs have negatively affected this individual in the long run and there is no turn around. Once the damage is done it is
Before going into further detail about Nathaniel’s psychological assessment, I will discuss background information and an overview of both disorders. To begin with, schizophrenia has been documented and diagnosed as early as 1809 described by John Haslam as a “form of insanity”. Eugene Bleuler proposed the term Schizophrenia and viewed this disorder as an “associative splitting,” a fragmented connection of functions of personality (Barlow & Durand, 2012). Contrary to popular belief, schizophrenia is not having a split mind or personality, but in actuality; it is a type of psychotic disorder that consist of a complex set of symptoms that may cause loss of contact with reality. Schizophrenia is over activity of the brain and is companied by positive and negative symptoms. To be diagnosed with schizoph...
Do you think to look at someone you can tell if they have Delusional Disorder? The most common symptom is the presence of delusions. These delusions have a grip on the person’s mind which has an unshakable belief that the delusions are true. The delusions can be either non-bizarre or bizarre. Some non-bizarre delusions can be either being poisoned, followed, and being conspired against. There are six different traits a
Schizophrenia is a mental disorder which disables the brain and leaves a person feeling psychotic. A person diagnosed with this disorder may see or hear things that other people don’t. They may also think that, if they are talking with someone, the other person is controlling his or her mind or is planning to hurt them in some way. This will result in the schizophrenic person withdrawing from any social interaction, or becoming very agitated.
According to the DSM-5, the diagnostic criteria of part A- characteristic symptoms for schizophrenia are delusions, hallucinations, disorganized speech (e.g., frequent derailment or incoherence), grossly disorganized or catatonic behavior, negative symptoms (i.e., diminished emotional expression or avolition) (APA, 2013), and John Nash suffered from all of them to some extent. The most salient of
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) is a multiaxial classification system for mental disorders. The first axis includes an extensive list of clinical syndromes that typically cause significant impairment. In the case of John Nash, his Axis I diagnosis would be paranoid schizophrenia. According to the text, “people with paranoid type schizophrenia have an organized system of delusions and auditory hallucinations that may guide their lives” (Comer, 2011, p. 364). Nash suffered delusions of persecution, fearing that people were out to get him.
The major obstacle for Ben is the struggle to cope with the antics of Gus. Gus has many idiosyncrasies that Ben finds intolerable. One example that is made very clear is gus’ inquisition. Gus questions everything, especially when the message will come. Ben overcomes this obstacle quite easily when he turns the gun on his own partner.