11-20-2006, 04:42 PM
A 28-year-old woman is brought to the office by her husband who
says that the police were called to their house last night because she
"brandished a knife at the neighbor." He says that his wife has been
"pretty crazy" for the past 8 months. It all started with her "believing
that their neighbor's son, who has been dead for years, has been
communicating with her through the shower faucet, and telling her to
kill his parents." At first, he thought that this was just a joke, but then
he began to realize that something had to be "off" because she began
to see faces of other dead acquaintances in the refrigerator. She
stopped her daily showers, started wearing dirty cloths from the
hamper, and cut off all communication with friends and relatives. She
was constantly so disheveled and "out there" that she was fired from
her job as a grocery store clerk. Approximately 5 months ago, there
was a 3-week period where she had difficulty sleeping, a 15-pound
weight loss, and there was a generalized "sadness about her." During
this period, she repeatedly expressed feelings of worthlessness, and
rarely got out of bed to watch television, which up until then had been
her most exciting activity. The husband says that she has recently
begun to complain about sleeping "troubles" again, and she has had
difficulty getting out of bed. She now says that she "needs to get out of
the office to kill those people once and for all." She does not take any
medications, use any drugs, or drink alcohol. The most likely diagnosis
is
A. brief psychotic disorder
B. delusional disorder
C. major depressive disorder
D. schizoaffective disorder
E. schizophrenia
F. schizophreniform disorder
says that the police were called to their house last night because she
"brandished a knife at the neighbor." He says that his wife has been
"pretty crazy" for the past 8 months. It all started with her "believing
that their neighbor's son, who has been dead for years, has been
communicating with her through the shower faucet, and telling her to
kill his parents." At first, he thought that this was just a joke, but then
he began to realize that something had to be "off" because she began
to see faces of other dead acquaintances in the refrigerator. She
stopped her daily showers, started wearing dirty cloths from the
hamper, and cut off all communication with friends and relatives. She
was constantly so disheveled and "out there" that she was fired from
her job as a grocery store clerk. Approximately 5 months ago, there
was a 3-week period where she had difficulty sleeping, a 15-pound
weight loss, and there was a generalized "sadness about her." During
this period, she repeatedly expressed feelings of worthlessness, and
rarely got out of bed to watch television, which up until then had been
her most exciting activity. The husband says that she has recently
begun to complain about sleeping "troubles" again, and she has had
difficulty getting out of bed. She now says that she "needs to get out of
the office to kill those people once and for all." She does not take any
medications, use any drugs, or drink alcohol. The most likely diagnosis
is
A. brief psychotic disorder
B. delusional disorder
C. major depressive disorder
D. schizoaffective disorder
E. schizophrenia
F. schizophreniform disorder
