Psychoses 01
Topic: Anatomy
Created on Friday, December 29 2006 by
Last modified on Friday, December 29 2006.
A 26 year-old male crabgrass biologist is brought by ambulance to the emergency room.
He is uncooperative, disheveled, and insists that he is the head of the Secret Service.
He complains of seeing visions of fabulous violet shrimp.
He is accompanied by his cousin, who states that he was lucid and rational until 5 days ago, when he also began to complain of nausea and headache.
Physical exam is significant for opisthotonus, repeated vomiting, high fever, and positive Kernig sign.
Of the following, which is the most appropriate diagnosis?
A) Substance-induced psychotic disorder B) Delusional disorder C) Schizophrenia D) Mood disorder with psychotic features E) Psychotic disorder due to a general medical condition
This question was created on December 29, 2006 by .
This question was last modified on December 29, 2006.
ANSWERS AND EXPLANATIONS
A) substance-induced psychotic disorder
This answer is incorrect.
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 no known substance exposures. (
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B) 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. (
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C) schizophrenia
This answer is incorrect.
The diagnosis of schizophrenia requires at least 6 months of continuous signs of psychological disturbance. This 6-month period must include at least 1 month of "active-phase" symptoms: delusions, halucinations, disorganized speech, grossly disorganized or catatonic behavior, or negative symptoms (affective flattening, alogia, or avolition). This patient's psychosis has an obvious organic cause. (
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D) mood disorder with psychotic features
This answer is incorrect.
Like schizoaffective disorder, the diagnosis of mood disorder with psychotic features requires both psychotic and mood symptoms. However, in mood disorder with psychotic features, the psychotic features are never present without the mood symptoms. When patient mood normalizes, the psychotic features resolve. This patient's psychosis has an obvious organic cause. (
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E) psychotic disorder due to a general medical condition
This answer is correct.
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. This patient has exam findings suggestive of meningitis, which can explain the psychotic symptoms. (
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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) | Advertising:
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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