DrVirgo
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A 27 year old man has an 8 year history of distrust and suspiciousness of others. He finds threatening meanings in what people say, even if the remark is complimentary. He feels people deceive him and is reluctant to confide in others lest they use that information to hurt him. He lacks close friends, shows emotional colneess, and often chooses solitary activities. At age 23, after losing a job, he was treated with an antipsychotic medication for 1 week. At that time, he believed people were looking at him in such a way as t indicate that thye were about to kill him, and he heard voices telling him to flee his home. Which of the following is the most likely diagnosis?
A. Delusional disorder, persecutory type
B. Paranoid personality disorder
C. Schizoid personality disorder
D. Schizophrenia, paranoid type
I'll post the right answer later but could someone please explain as it pertains to this case the difference between B and D?
Thanks.
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| bax
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b
odd n eccentric personality....
for schizophrenia paranoid type,
bizzare delusion, halucination , disorganised speech n behavior sh'd be thr with paranoid features
wht's d ans?
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| neurom
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what first came to my mind is symptoms duration. He/she was ALWAYS like this - personality disorder. Schizo starts at some point of their life, but initially they are normal.
I go with D.
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| DrVirgo
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Answer is
B. Paranoid personality disorder
I thought B at first but then changed it to D since he was Schizo in the past... Explanation says that it's B because of those typical features, but then goes on to say that Schizo can remit and relapse (exactly why I thought it was D), because as I thought once a Schizo, always a Schizo... But apparantly he is 27 and has had this for 8 years (PRIOR to the dx of Schizo at age 23 -only 4 years ago), so in this case a personality disorder would be right, not Schizophrenia.
weird question.
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| neurom
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ok, thanks DrVirgo, but yes it is a weird qiestion
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| hero
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Important difference is that schizo affects social and occupational functioning.
Probably one time loosing job is not occupational dysfunction.
Also no hallucinations - against schizo.
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| neurom
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hero wrote:
Important difference is that schizo affects social and occupational functioning.
Probably one time loosing job is not occupational dysfunction.
Also no hallucinations - against schizo.
"he heard voices telling him to flee his home"...how about this?
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| DrVirgo
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He heard voices when he was 23.
Now he is 27, so I guess Paranoid PD is better than Schizo.
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| anuba
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that was a tricky question. Most likely I would answer paranoid schizophrenia
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| angel^Doctor
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i believe B.
paranoid personality disorder patiens tend to develop symptoms of psychosis under stress.
ones of the creteria of diagnosing schizophrenia is duration of more than 6 months according to DSM which is not present here
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| Al Durra
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i believe B.
paranoid personality disorder patiens tend to develop symptoms of psychosis under stress.
ones of the creteria of diagnosing schizophrenia is duration of more than 6 months according to DSM which is not present here
this is exactly what i want to say
Guys , please pay attention to the duration of sx before choosing schizophrenia
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| peter90036
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why? is 8 years not more than 6 months?
the entire presentation is important here. not just the duration.
the episode of losing job and getting tx antipsychotic likely be a brief psychotic disorder
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| arlete
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That's why I don't like psychiatry.  
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| ansalshah
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| inkspot
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yeah B
he has a personality disorder, which start @ 18 yrs
schizo are young. look at ages around early 20's
I think this is a case of paranoid personality disorder with single episode of " brief psychotic disorder" which i guess is a distractor. the patient is currently not on any medications if he was a schizo he would have had more of such attacks without medications .
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