Psychotic disorders and schizophrenia are some of the most complicated and challenging diagnoses in the DSM. The symptoms of psychotic disorders may appear quite vivid in some patients; with others, symptoms may be barely observable. Additionally, symptoms may overlap among disorders. For example, specific symptoms, such as neurocognitive impairments, social problems, and illusions may exist in patients with schizophrenia but are also contributing symptoms for other psychotic disorders.
For this Assignment, you will analyze a case study related to schizophrenia, another psychotic disorder, or a medication-induced movement disorder.
To Prepare:
- Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing psychotic disorders. Consider whether experiences of psychosis-related symptoms are always indicative of a diagnosis of schizophrenia. Think about alternative diagnoses for psychosis-related symptoms.
- Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
- By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
- Consider what history would be necessary to collect from this patient.
- Consider what interview questions you would need to ask this patient.
- Identify at least three possible differential diagnoses for the patient.
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:
- Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
- Objective: What observations did you make during the psychiatric assessment?
- Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
- Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
Learning Resources
Required Readings
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American Psychiatric Association. (2022). Medication-induced movement disorders and other adverse effects of medication. In Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url= https://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425787.Medication_Induced_Movement_Disorders
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American Psychiatric Association. (2022). Schizophrenia spectrum and other psychotic disorders. In Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url= https://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425787.x02_Schizophrenia_Spectrum
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Boland, R. & Verduin, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.
- Chapter 5, “Schizophrenia Spectrum and Other Psychotic Disorders”
- Chapter 2 only section 2.14, “Early-Onset high school in 11th grade, was pregnant and had abortion. allergies: Clozari high school in 11th grade, was pregnant and had abortion. allergies:
Background: Patricia was brought in under a emergency evaluation order after her best friend, Felicia, after the police for Patricia locking herself in a closet and screaming loudly for over an hour. EMS was able to calm her with a small dose of Ativan enroute to the emergency department. This is Patricia’s third presentation to the emergency room in 2 weeks. She had one psychiatric hospitalization around this same last year. No self-harm behaviors but has assaulted other in the past. No hx of TBI. Sleeps 1–2-hour increments for total of 6 hrs. daily, refuses to sleep at night. Refused vitals, wt., refuses labs, not cooperative. She obtains SSDI. She lives in Cameron, Montana. She denies ever using any drugs and drinks one glass wine weekly. She has a sister who is five years older, both parents deceased in the last three years. She has no children, her husband is out of town, truck driver. Family history includes that her father had two previous inpatient psychiatric hospitalizations for paranoia Mother had history of bipolar depression. Paternal grandmother had “shock therapy”. Denies history of trauma experience, but her friend reports parents death was extremely difficulty for Patricia. no current legal charges. dropped out of high school in 11th grade, was pregnant and had abortion. allergies: Clozaril .
Media. (Producer). (2018). Training title 134 [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa tch/training-title-134