Review the vignettes included in the lecture, and then diagn…

Review the vignettes included in the lecture, and then diagnose Robin, and Becky with a psychotic disorder. What are the justifications for your diagnosis? Include differential diagnoses that were considered and discarded.

Diagnosing a psychotic disorder requires a comprehensive understanding of the clinical presentation, careful analysis of the symptoms exhibited by the patients, and the consideration of various differential diagnoses. In this assignment, we will assess two individuals, Robin and Becky, utilizing the information provided in the vignettes to make a diagnosis of a psychotic disorder, along with supporting justifications. Furthermore, we will explore alternative diagnoses that were initially considered but ultimately excluded.

Vignette 1:
Robin is a 35-year-old male who is experiencing significant distress and impairment in his daily functioning. He reports hearing strange voices that are not audible to others. These voices command him to engage in self-harming behaviors and express derogatory statements about himself. Robin exhibits paranoid thoughts, believing that someone is constantly watching him. He reports occasional visual hallucinations, mostly seeing shadowy figures lurking in his peripheral vision. Additionally, Robin’s family has noticed a decline in his self-care, as he has neglected personal hygiene and appears agitated, often pacing around the house.

The symptoms described in Robin’s case align with the criteria for a diagnosis of schizophrenia, which is a primary psychotic disorder. The presence of auditory hallucinations, delusions, negative symptoms (evident through the decline in self-care and agitated behavior), and visual hallucinations collectively indicate a psychotic disorder. Furthermore, his symptoms have persisted for a significant duration, as evident from the deterioration in his daily functioning and impairment.

Differential diagnoses considered for Robin include substance-induced psychotic disorder and mood disorder with psychotic features. However, substance-induced psychotic disorder can be ruled out, as there is no indication of recent substance use or intoxication in the vignette. Moreover, the duration and severity of Robin’s symptoms suggest that they are not solely attributed to a mood disorder with psychotic features. Therefore, the most appropriate diagnosis for Robin’s case is schizophrenia.

Vignette 2:
Becky is a 22-year-old female who presents with symptoms that warrant consideration of a psychotic disorder. She reports feeling detached from reality and frequently experiences episodes during which she loses touch with her surroundings. Becky describes experiencing persistent and intrusive thoughts that are nonsensical and unrelated to her daily life. She reports occasional visual hallucinations, seeing objects that are not present, as well as auditory hallucinations where she hears multiple indistinct voices speaking at once, despite no external stimuli. Furthermore, Becky has expressed mild suspicion towards her friends, believing that they are talking about her behind her back.

Becky’s symptoms align with the diagnostic criteria for schizoaffective disorder, a condition characterized by features of both schizophrenia and a mood disorder. The presence of hallucinations, delusions, and cognitive disturbances such as detached feelings and intrusive thoughts support the diagnosis of schizoaffective disorder. Additionally, the duration and frequency of her symptoms suggest a chronic and enduring nature, similar to what is typically observed in psychotic disorders.

When considering differential diagnoses for Becky, it is crucial to distinguish between schizophrenia and schizoaffective disorder. The primary distinction lies in the presence of mood disorder symptoms. In Becky’s case, there are no clear indications of mood disturbances, such as depressive or manic episodes. Therefore, the possibility of a mood disorder with psychotic features is not adequately supported. Consequently, the most fitting diagnosis for Becky’s case is schizoaffective disorder.

In conclusion, after carefully assessing the vignettes for Robin and Becky, a diagnosis of a psychotic disorder can be made. Robin’s symptoms correspond to a diagnosis of schizophrenia, based on his auditory and visual hallucinations, delusions, negative symptoms, and impaired daily functioning. Becky’s symptoms, on the other hand, indicate schizoaffective disorder, characterized by hallucinations, detached feelings, intrusive thoughts, and mild suspiciousness. By considering alternative diagnoses, such as substance-induced psychotic disorder and mood disorder with psychotic features, we were able to exclude these possibilities and arrive at the most appropriate diagnoses for Robin and Becky’s cases. These findings emphasize the importance of a thorough evaluation, utilizing comprehensive diagnostic criteria, to accurately diagnose psychotic disorders.