Roger is a 19 year old young man born and raised in Arkansas. He is brought into treatment by his parents. The parents are present in the initial interview session. Mother tells you that Roger, "is no longer the sweet gentle boy I raised." Roger's father is a minister and tells you that he had always hoped that Roger would one day follow in his footsteps and join him in ministry. The parents tell you that over the last year, Roger has had some very odd behavior. They often find him sitting alone in his room having dialogues with people. When they approach him, Roger tells them to be quiet or they will disturb his ability to talk to the other side. The parents believe that Roger is using drugs and feel this is behind his bizarre behavior. Though Roger has few friends, the parents feel that the ones he does have "are just weird and dress funny." In taking a family history, you discover that Roger's maternal grandmother was institutionalized, but his mother cannot tell you why as it was "hush hush" in her family and no one was allowed to mention it.
Formulate a Differential Diagnosis for Roger. What are your diagnostic considerations and why? Support your ideas by discussing what you see in the vignette utilizing all course readings thus far. What information would you need to look for to confirm your diagnostic impression and why?
My diagnostic considerations for Roger would be to investigate Schizophrenia as a potential diagnosis. Though his parents believe that his behavior is caused by drugs, the hallucinations that Roger is experiencing are likely not caused by drugs themselves. Also, the family history with his grandmother having been institutionalized is a sign that perhaps the "talking to the other side" is not drug induced ...
The solution discusses the diagnostic presentation.