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A Differential Diagnosis of Schizophrenia

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Does this information give enough intial information to make a diagnosis? What else should be added?

Physician's interview of Donald:
- Donald is a 33 year old young man, with a relatively high intelligence level
- Currently living in a sheltered community setting
- Unemployed. Has held positions but only for a few days.
- Few but frequent periods of hospitalizations.
- Hospitalization triggered by episodes of hearing voices which taunt him through insults
- In social situations, he feels awkward and unsure of himself and inappropriate
- Mid teenage years began to withdraw and isolate himself from friends and family
- Age 17, first began to hear voices
- Initially Donald thought that the voices came from a neighbor's house and transmitted through the television set. He thought the voices he heard were planning to harm him.
- He now thinks that the voices may be coming from him.
- During episodes sometimes he can be heard arguing with the voices
- When episodes pass, he can seem to ignore the voices but they are never truly gone.
- No evidence of drug use
- Prior to first breakdown , he lived a relatively normal life; attending school and doing well, interacted with peers

Donald's mental disorder seems to be a form of schizophrenia. In order to have a more complete and definitive diagnosis it would be helpful to obtain a family history. This mental disorder is thought to be genetic. Donald does have hallucinations but does not suffer from disorganized speech; or as yet has not revealed a speech component. Finding friends and/or family is essential so that in-depth background can be formulated. Until then, a medical physical must be completed in order to rule out a psychotic disorder caused by a general medical condition. Since Donald's symptoms have been present since he was 17, it would appear that he does have some type of schizophrenic disorder. At present he appears to be well groomed. There has been no mention of lack of energy or lack of affect at this time.

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Solution Preview

The best source for you to answer this question is the Diagnostic and Statistical Manuel of Mental Disorders. DSM IV-TR. According to the DSM, the criteria for a diagnosis for schizophrenia are broken down into 5 categories:

A. Characteristic symptoms, which include, hallucinations, disorganized speech, disorganized or catatonic behavior, delusions and negative symptoms such as having a flat affect.
B. Social and or occupational dysfunction. This would include relationships, taking care or oneself , significant difficulty at work or school
C. Duration: The DSM requires that there should be continuous signs or symptoms for a least 6 ...

Solution Summary

The purpose of this solution is to be able to make a sound diagnosis of schizophrenia based on the case study presented. This solution includes the breakdown of the types of schizophrenia using the Diagnostic and Statistical Manuel of Mental Disorders.