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  #1  
Old 09-01-2012
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Psyche Suicidal and homocidal patient in the ER!

A 35 y.o. homeless comes to the ER saying that he needs to be admitted. He is vague, irritable, makes poor eye contact. He claims to be suicidal, homicidal and says that if he is discharged and kills someone, the hospital will be to blame. He admits using marijuana and cocaine in the past. There are no abnormalities on P/E. Psychiatric examination shows tight associations but no evidence of psychotic symptoms. Test for drugs in urine is negative. Which of the following conditions should be most likely ruled out first?

a) delusional disorder
b) factitious disorder
c) malingering
d) schizophrenia
e) substance-induced mood disorder
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  #2  
Old 09-01-2012
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i guess the pt. is malingering......
i didnt catch the question exactly.......
condition that can ruled out first is-----a)delusional disorder
condition that have to rule out first is -----d)schizophrenia
but, i would like to go with D

Last edited by venky2600; 09-01-2012 at 03:09 AM.
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Old 09-01-2012
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Default b) factitious disorder

confused between B and C but i am getting a sense that he is faking symptoms but they are not intentional.
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Old 09-01-2012
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Default malingering

as the patient is homeless, may be he wants to be in (institutionalized ) care
so I go with malingering (he is trying to get some benefit I think)
so whats the answer?
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Old 09-01-2012
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B?? Factitious ???
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Old 09-01-2012
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C. Malingering

He is volunteering all the info...For a gain, which is Shelter in this case.
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Old 09-01-2012
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Default you guys are right

ya indications more promising for malingering.
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Old 09-02-2012
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what's the answer Casandra..?
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Old 09-02-2012
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Correct Answer correct answer :)

The answer is c) malingering

however no satisfactory explanation is provided.
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Old 09-02-2012
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Quote:
Originally Posted by Casandra View Post
The answer is c) malingering

however no satisfactory explanation is provided.
OK, what's the diagnosis of this case, if malingering has been ruled out first..
factitious disorder...?
anyways thanx for the answer
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