Schizophrenia or Schizophreniform or Schizoaffective Disorder - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 01-29-2012
tyagee's Avatar
USMLE Forums Master
 
Steps History: ---
Posts: 1,365
Threads: 648
Thanked 591 Times in 355 Posts
Reputation: 601
Psyche Schizophrenia or Schizophreniform or Schizoaffective Disorder

A 25-year-old woman was found walking nude in the shopping mall. When asked
why, she replied, "I know they all want me." She seemed quite undisturbed by her
behavior and mentioned that she had not slept for the last 9 days. Her speech
was pressured and she had some evidence of psychomotor agitation. She later informed
you that she had another episode a few months ago during which she heard voices
and believed that others were going to kill her. She presented with those symptoms
for approximately 7 months and was fired from her job due to the voices.

please give the reason for the most likely diagnosis you think? i am confused...

Last edited by tyagee; 01-29-2012 at 12:07 AM. Reason: dhc
Reply With Quote Quick reply to this message



  #2  
Old 01-29-2012
dr-ahmed's Avatar
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 333
Threads: 61
Thanked 390 Times in 90 Posts
Reputation: 400
Default > 6 months

> 6 months

schizophrenia
Reply With Quote Quick reply to this message
The above post was thanked by:
Mondoshawan (01-31-2012)
  #3  
Old 01-29-2012
tyagee's Avatar
USMLE Forums Master
 
Steps History: ---
Posts: 1,365
Threads: 648
Thanked 591 Times in 355 Posts
Reputation: 601
Default

Quote:
Originally Posted by dr-ahmed View Post
> 6 months

schizophrenia
its wrong...sorry!
Reply With Quote Quick reply to this message
 
  #4  
Old 01-29-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 590
Threads: 31
Thanked 1,233 Times in 411 Posts
Reputation: 1257
Default Schizoaffective

It sounds like schizoaffective disorder, bipolar type: mix of psychotic and mood symptoms, with a manic episode.

DSM IV-TR criteria:
  1. Two (or more) of the following symptoms are present for the majority of a one-month period (or a shorter period of time if symptoms got better with treatment):
    • delusions
    • hallucinations
    • disorganized speech (e.g., frequent derailment or incoherence) which is a manifestation of formal thought disorder
    • grossly disorganized behavior (e.g. dressing inappropriately, crying frequently) or catatonic behavior
    • negative symptoms—e.g., affective flattening (lack or decline in emotional response), alogia (lack or decline in speech), avolition (lack or decline in motivation), anhedonia (lack or decline in ability to experience pleasure), social withdrawal (sometimes called social anhedonia).
    If the delusions are judged to be bizarre, or hallucinations consist of hearing one voice participating in a running commentary of the individual's actions or of hearing two or more voices conversing with each other, only that symptom is required to meet criterion A above. The speech disorganization criterion is only met if it is severe enough to substantially impair communication.
  2. And at some time during the illness there is either one, two or all three of the following:
    • major depressive episode
    • manic episode
    • mixed episode
  3. During the illness, delusions or hallucinations were present for a minimum of two weeks, without major mood symptoms.
  4. For a substantial part of the overall duration of both the active and residual period of the illness, symptoms meeting criteria for a mood episode are present.
  5. Symptoms are not caused by drug abuse, medication or another medical condition.

C and D are too complex to be included in a Step 2 stem, I think, and shouldn't be used to rule out psychoaffective disorder on the test. I'm not sure if psychoaffective will make it to the DSM-V or not; it may be split (along Kraepelin's lines of psychosis v. mood), since it seems like the two aspects are often treated separately.

Take-home criteria:
  • Criteria for schizophrenia met = schizophrenia
  • Plus manic, depressive, or mixed episode = schizoaffective
Reply With Quote Quick reply to this message
The above post was thanked by:
pass7 (01-29-2012)
  #5  
Old 01-29-2012
nikhilesh's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 45
Threads: 3
Thanked 29 Times in 22 Posts
Reputation: 39
Default

i think its schizoaffective disorder with mania....... she hasnt slept for days... pressured speech and the fact that her affact is blunted coz she doesnt care shes naked... also the onset of this episode is a few days...
i think the previous hx of having auditory halucinations is a distractor.... she may have had that in the past but right now she is here with diff symptoms and signs...
Reply With Quote Quick reply to this message
  #6  
Old 01-31-2012
tyagee's Avatar
USMLE Forums Master
 
Steps History: ---
Posts: 1,365
Threads: 648
Thanked 591 Times in 355 Posts
Reputation: 601
Default

this q is from kaplan notes psychiatry and guess what? ans is schizophreniform!!! i cant believe...[ in chapter schizophrenia under heading schizophreniform]
any 1 please reply....
Reply With Quote Quick reply to this message
The above post was thanked by:
Mondoshawan (01-31-2012)
  #7  
Old 01-31-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 590
Threads: 31
Thanked 1,233 Times in 411 Posts
Reputation: 1257
Default

A 25-year-old woman was found walking nude in the shopping mall. When asked why, she replied, "I know they all want me." She seemed quite undisturbed by herbehavior and mentioned that she had not slept for the last 9 days. Her speech was pressured and she had some evidence of psychomotor agitation.
(This sounds like a manic episode - Mondoshawan)
She later informed you that she had another episode a few months ago during which she heard voices and believed that others were going to kill her.
(and this sounds like psychosis - M)
She presented with those symptoms for approximately 7 months and was fired from her job due to the voices.

Quote:
Originally Posted by tyagee
this q is from kaplan notes psychiatry and guess what? ans is schizophreniform!!! i cant believe...[ in chapter schizophrenia under heading schizophreniform]
any 1 please reply....
That's strange! I think of the timing as:
  • <1 month: brief psychotic disorder
  • 1-6 months: schizophreniform
  • >6 months: schizophrenia
So even if they didn't think they were describing a manic episode, the qualifier that she had had the symptoms for seven months should have put her in the schizophrenia category. Maybe there was a typo? Kaplan is usually pretty well edited
Reply With Quote Quick reply to this message
The above post was thanked by:
sadaf1987 (07-18-2015)



Reply

Tags
Psychiatry-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Major depression vs Schizoaffective disorder Verocita USMLE Step 2 CK Forum 6 03-11-2013 09:37 AM
Schizoaffective vs Schizophreniform vs Schizophrenia apx85 USMLE Step 1 Forum 5 05-23-2011 02:56 PM
Conduct Disorder Vz Antisocial Personality Disorder Ayshee USMLE Step 2 CK Mnemonics 1 10-30-2010 11:33 AM
The difference between Conduct Disorder and Oppositional Defiant Disorder Telsa-Farad USMLE Step 2 CK Forum 2 06-15-2010 03:08 PM
Delusional Disorder or Brief Pshychotic Disorder obgynaim USMLE Step 1 Forum 1 12-20-2009 09:06 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)