Schizophrenia Spectrum & Other Psychotic Disorders

Case 1
Stephen Walker is a 19-year-old white male belonging to middle economic class, and currently a college student. He is a physically active young man who is involved in strenuous activities such as weight lifting, break dancing, snowboarding, and skateboarding. Two years ago, the patient sought medical attention from a physician citing in the wrist. Two years later, Walker has visited ten physicians complaining of physical pain in various parts of his body such as wrist, shoulder, knees, and perennials among others. He mentions that he sustains these injuries during his physical activities. Walker believes that, two years ago, the government implanted a monitoring chip in his body to control him. He argues that the reason why he keeps falling is that whenever he does things that the CIA does not want him to do, the chip sends impulses in this body, making him fall. The also hears voices telling him that he has a chip inside his body. There is no evidence that Walker has been abusing alcohol or any narcotic.

Diagnose(s): 295.90 (F20.9) Schizophrenia, disillusion of persecution, auditory hallucination, for more than 6 months.

Case 2
Lisa Miranda is a 31-year-old African American female from a low social class. She was presented into the emergency room by police officers after she stabbed a cab driver. The patient claims that the car driver attacked and raped him while the police officers were watching. She also says that she has been instructed by the angels, through the voices in her head, to execute justice on the rapist and the dirty cops. Family members also reported that, 3 months ago, the patient started claiming that she talks to god and angles that have been directing her of what to do. Toxicology and the historical report show no evidence of drug abuse.

Diagnose(s): 295.40 (F20.81) Schizophreniform Disorder, auditory hallucination, delusions, both have taken more than a month.

Case 3
Haruki Yuto is a 14-year-old Japanese-American boy, from a family of middle social status. Yuto’s parents brought him in with complaints of academic decline. Two years ago, the patient reposted that he hears the voices of an unknown person. He believes that his family has colluded with this unknown person to tease him. The parents also reported that they often find him wide awake past midnight. Yuto’s academic performance and handwriting have deteriorated over the last 2 years. However, physical examination shows no significant medical concern.

Diagnose(s): 295.90 (F20.9) Schizophrenia, disillusion of persecution, auditory hallucination, for more than 6 months.

Case 4
Alice Tacker is a 39-year-old white single woman who is unemployed. At the age of 23, she was diagnosed with an unidentified psychiatric disorder. However, six months ago, she stopped using her drugs insisting that somebody has poisoned them. Her sleep has deteriorated and she often remains indoors. She claims that she is “the wife of Jesus Christ” and that she has to stay isolated and remain pure as she waits for her “husband” to come back. She hears the voices of Jesus Christ talking to her telling her to wait for him. She also exhibits incoherent speech with irrelevant responses. Tacker’s response and toxicology report reveal she does not use alcohol or any illegal drugs.

Diagnose(s): 301.22 (F21) Schizotypal Personality Disorder, auditory hallucination, delusion, and incoherent speech, for a period of more than 3 months.

Case 5
Salma Martìnez is a 32-year-old Latin-American single woman from a middle social class. Since three years ago, Martìnez has exhibited poor sleep, talkativeness, and wandering away from home. Whenever her caregiver tries to prevent her from getting away from home, she becomes violent and aggressive. She claims that she hears a voice in her head telling her that she should stay away from home. She believes that is she continues to stay at home, she will die prematurely. She insists that if they force her to stay at home, she will kill herself so that she does not wait for a painful death. Mental examination revealed that the patient is also depressed and has incoherent speech. Martìnez denied the use of any illicit drug or alcohol.

Diagnose(s): 295.70 (F25.1) Schizoaffective Disorder – Depressive Type, persecutory delusions, auditory hallucinations, and paramnesia of homicide for a period of more than 6 months.

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