Psychotic Disorders & Schizophrenia

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Questions and Answers

What is required for a substance/medication-induced psychotic disorder to be diagnosed?

Psychotic symptoms persist for a substantial period after cessation of severe intoxication or acute withdrawal

Psychotic symptoms that are substantially in excess of what would be expected given the type or amount of the substance used or the duration of use

Psychotic symptoms that occur during a period of sustained substance abstinence

All of the above (correct)

What set of specifiers is included in the DSM-5 diagnostic criteria for substance/medication-induced psychotic disorder?

With onset during intoxication and With onset during withdrawal (correct)

With catatonia and Without catatonia

With onset before intoxication and With onset during intoxication

With good prognostic features and Without good prognostic features

A patient with systemic lupus erythematosus, being treated with corticosteroids, witnesses a serious motor vehicle accident and begins to have disorganized speech. What diagnosis best fits this clinical picture?

Major depressive disorder with psychotic features

Schizophrenia

Substance/medication-induced psychotic disorder

Psychotic disorder due to another medical condition (correct)

What is a characteristic of psychotic symptoms in substance/medication-induced psychotic disorder?

They are substantially in excess of what would be expected given the type or amount of the substance used or the duration of use Signup and view all the answers

What is not a criterion for substance/medication-induced psychotic disorder?

Psychotic symptoms that are caused by a general medical condition Signup and view all the answers

A patient with a history of substance use disorder is brought to the emergency department with psychotic symptoms. What is the most important factor in determining the diagnosis?

The presence of psychotic symptoms that persist after cessation of severe intoxication or acute withdrawal Signup and view all the answers

What is the primary difference between substance/medication-induced psychotic disorder and psychotic disorder due to another medical condition?

The underlying cause of the psychotic symptoms Signup and view all the answers

A patient with a history of schizophrenia is brought to the emergency department with psychotic symptoms. What is the most likely diagnosis?

Schizophrenia Signup and view all the answers

What is the specifier included in the DSM-5 diagnostic criteria for substance/medication-induced psychotic disorder?

With onset during intoxication Signup and view all the answers

Which psychotic disorder is associated with systemic lupus erythematosus?

Psychotic disorder due to another medical condition Signup and view all the answers

Which of the following would not be diagnosed as 'other specified schizophrenia spectrum and other psychotic disorder'?

Postpartum psychosis that meets criteria for a depressive or bipolar disorder Signup and view all the answers

Which of the following patient presentations would be classified as psychotic?

A patient believes he is being followed by a secret police organization that is focused exclusively on him Signup and view all the answers

In which of the following disorders can psychotic symptoms not occur?

Anxiety disorders Signup and view all the answers

Which of the following is a characteristic of psychotic symptoms in substance/medication-induced psychotic disorder?

They are temporally related to use of a substance Signup and view all the answers

What is the correct diagnosis for a patient who experiences auditory and persecutory delusions for 2 months, followed by a full major depressive episode, and then the depressive episode resolves but the psychotic symptoms persist?

Schizoaffective disorder Signup and view all the answers

What is true about the incidence of schizoaffective disorder?

The incidence is higher in women Signup and view all the answers

Which of the following would not be evidence of an independent psychotic disorder?

Psychotic symptoms that only occur during the intoxication period Signup and view all the answers

How common is schizoaffective disorder relative to schizophrenia?

One-half to one-third as common Signup and view all the answers

What is the primary difference between schizoaffective disorder and schizophrenia?

The presence of mood symptoms in schizoaffective disorder Signup and view all the answers

What is a characteristic of psychotic symptoms in substance/medication-induced psychotic disorder?

They persist for a substantial period after cessation of severe intoxication or acute withdrawal Signup and view all the answers

Which of the following is not a diagnostic possibility for inclusion in the differential diagnosis of a patient with a history of alcohol dependence and schizophrenia who presents with psychotic symptoms?

Major depressive disorder Signup and view all the answers

What is the primary factor in determining the diagnosis of a patient with a history of substance use disorder who presents with psychotic symptoms?

The presence of psychotic symptoms in excess of what would be expected given the substance used Signup and view all the answers

Which of the following is NOT a characteristic of psychotic symptoms in psychotic disorder due to another medical condition?

They are only present during intoxication Signup and view all the answers

A patient with a history of substance use disorder is brought to the emergency department with psychotic symptoms that persist for several days after cessation of intoxication. What is the most likely diagnosis?

Substance/medication-induced psychotic disorder Signup and view all the answers

How long must symptoms persist for a diagnosis of schizophrenia?

6 months Signup and view all the answers

Which condition is characterized by at least 1 month of delusions without other prominent psychotic symptoms?

Delusional disorder Signup and view all the answers

Which disorder includes delusions or hallucinations for at least 2 weeks in the absence of a major mood episode?

Schizoaffective Disorder Signup and view all the answers

What is the maximum duration of symptoms for a diagnosis of Brief Psychotic Disorder?

1 month Signup and view all the answers

Which disorder is diagnosed when symptoms persist for less than 6 months but more than 1 month?

Schizophreniform Disorder Signup and view all the answers

Study Notes

Neurodevelopmental Disorders

Significant global intellectual impairment results in a full-scale IQ of 75, with a persistent reading deficit and mild impairment in adaptive functioning, leading to a diagnosis of Major Neurocognitive Disorder due to Traumatic Brain Injury.

Diagnosis of Global Developmental Delay

A diagnosis of global developmental delay is inappropriate when the patient's scores on psychometric tests suggest intellectual disability, but there is insufficient information about adaptive functional skills.
The diagnosis is typically made in children younger than 5 years of age, and the etiology can usually not be determined.

DSM-5 Introduction

DSM-5 has moved to a non-axial documentation of diagnosis, replacing the multiaxial system in DSM-IV.
The Global Assessment of Functioning (GAF) Scale (DSM-IV Axis V) is no longer a separate category and should not be coded in DSM-5.
DSM-5 replaced the "not otherwise specified" (NOS) designation with two options for clinical use: Other Specified [disorder] and Unspecified [disorder].

Autism Spectrum Disorder

Symptoms of autism spectrum disorder include deficits in nonverbal communicative behaviors, restricted and repetitive patterns of behaviors, and social and communication impairments.
A 15-year-old boy with a long history of nonverbal communication deficits, odd speech tonality and phrasing, and awkward body language may be diagnosed with autism spectrum disorder.
A 10-year-old boy with hand-flapping, finger flicking, repetitive behaviors, and restricted interests may also be diagnosed with autism spectrum disorder.

Speech Sound Disorder

A 4-year-old boy who struggles with speech articulation and has a normal IQ may be diagnosed with a speech sound disorder.
A 6-year-old boy who struggles with grammar, sentence construction, and vocabulary, and interjects "and" between words, may be diagnosed with a language disorder or an expressive language disorder.