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  #1  
Old 07-27-2014
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Default A 24-year-old man with unusual behavior

A 24-year-old man is brought to the emergency department by his mother after barricading himself in his apartment. For 8 months, he has believed that aliens follow him and control his mind. He was fired from his part-time job 6 months ago because of unusual behavior. There are no other apparent psychosocial stressors. His paternal grandmother has major depressive disorder. He does not use drugs, but his mother states that he frequently drinks beer. There is no disturbance of mood, sleep, or appetite. Examination shows an extremely agitated and suspicious patient. There is a 1 x 1-cm abrasion in the right frontal area. His blood alcohol concentration is 0.5 mg/dL, and serum γ-glutamyltransferase (GGT) activity is 40 U/L (N=5–50). Which of the following is the most likely diagnosis?

(A) Alcohol-induced mood disorder
(B) Bipolar disorder, manic
(C) Brief psychotic disorder
(D) Schizoaffective disorder
(E) Schizophrenia, paranoid type
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  #2  
Old 07-27-2014
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E) Schizophrenia, paranoid type
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Old 07-27-2014
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I m guessing E
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  #4  
Old 07-27-2014
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E patient has been exhibiting symptoms for over 8 months, so most likely schizophrenia.
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Old 07-27-2014
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I think its EE
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Old 07-27-2014
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Oh ok it's E
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I would appreciate if everyone writes why their choice is correct and why other choices are incorrect.
The whole idea is to have a discussion to to learn.

For example, among answer choices in this question:

(A) Alcohol-induced mood disorder-Unlikely since GGT normal and no disturbance of mood

(B) Bipolar disorder, manic -Unlikely since no h/s/o manic episode (no disturbance of mood, sleep, or appetite)

(C) Brief psychotic disorder -Unlikely since 8 months duration, no psychosocial stressors.

(D) Schizoaffective disorder -No h/s/o depression (no disturbance of mood, sleep, or appetite.)

(E) Schizophrenia, paranoid type - Age, delusion, hallicination, suspicious --The correct answer.
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The above post was thanked by:
hyndavi (07-28-2014), olayiwola-aims (07-27-2014)



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