Psychotic Disorders And Schizophrenia ✓ Solved

Psychotic Disorders And Schizophrenia Are Some Of The Most Complicated

Psychotic disorders and schizophrenia are some of the most complicated and challenging diagnoses in the DSM. The symptoms of psychotic disorders may appear quite vivid in some patients; with others, symptoms may be barely observable. Additionally, symptoms may overlap among disorders. For example, specific symptoms, such as neurocognitive impairments, social problems, and illusions may exist in patients with schizophrenia but are also contributing symptoms for other psychotic disorders.

For this Assignment, you will analyze a case study related to schizophrenia, another psychotic disorder, or a medication-induced movement disorder. To prepare, review this week’s Learning Resources and consider their insights about assessing and diagnosing psychotic disorders. Think about whether experiences of psychosis-related symptoms are always indicative of a diagnosis of schizophrenia and consider alternative diagnoses for psychosis-related symptoms. Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete your assignment, and review the Comprehensive Psychiatric Evaluation Exemplar to understand an example of a completed evaluation document.

By Day 1 of this week, select a specific video case study from the Video Case Selections in the Learning Resources. View your assigned video case and review the additional data in the “Case History Reports” document, keeping in mind the requirements of the evaluation template. Consider what history you would need to collect from the patient and what interview questions would be necessary. Additionally, identify at least three possible differential diagnoses for the patient.

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and the critical-thinking process used to formulate the primary diagnosis. Incorporate the following elements in your responses within the template:

Subjective: Describe the details provided by the patient regarding their chief complaint and symptomatology. What information did the patient give that guided your differential diagnosis? Include the duration and severity of their symptoms and how these symptoms impact their functioning in daily life.

Objective: Summarize the observations made during the psychiatric assessment. Consider appearance, behavior, speech, mood, thought process, and any other relevant behavioral indicators.

Assessment: Discuss the results of the patient’s mental status examination. Identify your differential diagnoses, providing at least three possible diagnoses in order of likelihood, with supporting evidence. Compare each diagnosis against DSM-5 criteria, explaining what features support or rule out each diagnosis. Describe the critical-thinking process that influenced your choice of the primary diagnosis, noting pertinent positives and negatives for the case.

Reflection notes: Reflect on what could be done differently if the session were conducted again. Discuss legal and ethical considerations beyond confidentiality and consent, such as assessing risk factors, ensuring culturally competent care, and addressing social determinants of health that may influence diagnosis and treatment. Consider health promotion and disease prevention strategies tailored to the patient's age, cultural background, socioeconomic status, and other relevant risk factors.

Sample Paper For Above instruction

The case under review involves a 28-year-old male patient presenting with auditory hallucinations, paranoid delusions, social withdrawal, and disorganized speech over the past six months. The patient's chief complaints include hearing voices commenting on his actions, believing others are plotting against him, and withdrawing from social interactions. These symptoms have progressively worsened, severely impairing his occupational and social functioning. The patient reports minimal insight into his condition, yet expresses concern about his declining performance at work and increasing isolation.

During the psychiatric assessment, the clinician observed disheveled appearance, paranoid affect, tangential speech, and some disorganized thought processes. The patient's mood was euthymic but with evident idea of reference and persecutory themes. His speech was pressured at times, with tangentiality and flight of ideas. No evident suicidal or homicidal ideation was present, but the patient appeared suspicious of the clinician's intentions, maintaining that he couldn't trust anyone. The mental status examination supported the presence of psychosis, with notable deficits in reality testing.

The differential diagnoses considered include Schizophrenia, Schizoaffective Disorder, and Substance-Induced Psychosis. DSM-5 criteria for schizophrenia require two or more characteristic symptoms—such as hallucinations, delusions, disorganized speech—persisting for at least six months, with at least one month of active-phase symptoms. The presence of persistent hallucinations and delusions fits this diagnosis, and the duration aligns with DSM criteria. Schizoaffective disorder was considered because of mood-related symptoms, but the absence of mood disorder episodes concurrent with psychosis makes this less likely. Substance-induced psychosis was ruled out due to the patient's denial of drug use and no evidence of intoxication or withdrawal signs during assessment.

The critical-thinking process involved evaluating symptom onset, duration, and impact, in conjunction with DSM-5 criteria. The chronicity and characteristic presentation support a primary diagnosis of schizophrenia. Pertinent positives include auditory hallucinations, paranoid delusions, and disorganized speech, while negatives such as lack of mood disorder episodes and absence of substance use histories helped rule out other diagnoses.

If conducting the session again, I would employ a more in-depth exploration of substance use history and include collateral information from family members or significant others to corroborate subjective reports. Ethically, it is important to consider the patient's autonomy, especially if their insight is impaired. Legal considerations include potential involuntary commitment if risk to self or others escalates. Culturally competent care entails understanding the patient’s cultural background, which may influence symptom expression and interpretation, requiring tailored communication and engagement strategies. Health promotion would involve psychoeducation about the illness, early intervention to prevent relapse, and social support planning, considering socioeconomic barriers that may impede access to care.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Mueser, K. T., & McGurk, S. R. (2004). Schizophrenia. The Lancet, 363(9426), 2063-2072.
• Heinrichs, D., & Buchanan, R. (2020). Psychosis and Schizophrenia: Clinical Features and Assessment. New York: Oxford University Press.
• Jongsma, A. E., & Yung, A. R. (2015). Early intervention in psychosis. Psychiatry, 81(6), 454-461.
• Green, M. F. (2016). Cognitive deficits and functional outcome in schizophrenia and bipolar disorder. Journal of Clinical Psychiatry, 77(8), e1027–e1032.