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Brief psychotic disorder
4%
3/76
Schizophreniform disorder
78%
59/76
Schizophrenia
8%
6/76
Schizoid personality disorder
Schizotypal peronsality disorder
0%
0/76
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This male's schizophrenia-like symptoms have lasted 3 months, which suggests a diagnosis of schizophreniform disorder. Schizophrenia is a chronic disorder marked by periods of psychosis and disturbed behavior, with a decline in function lasting > 6 months. The diagnosis requires 2 or more positive (delusions, hallucinations, disorganized speech, or disorganized/catatonic behavior) or negative (flat affect, social withdrawal, lack of motivations, speech or thought) symptoms. If the symptoms last for < 1 month, the diagnosis is brief psychotic disorder. If they last between 1-6 months, then it is schizophreniform disorder. Treatment consists of administering an antipsychotic for schizophrenia. Schultz et al. discuss the typical presentation of schizophrenia, which can be abrupt or insidious. Patients typically develop the symptoms gradually, such as social withdrawal, flat affect, loss of interest in their careers or school, and unusual behavior. Many people will see this behavior as a phase; however, once the psychosis begins, family members or close friends often become worried. Hung et al. review the case of an individual with schizophreniform disorder treated with the anti-psychotic, olanzapine. As with any therapy, the side effect profile is something to consider when using antipsychotic medications. This 17-year-old male hospitalized for psychotic symptoms developed hypothermia and rhabdomyolysis after he was treated with olanzapine. Supportive care was administered, the symptoms resolved within two weeks, and the patient remained on the medication. Incorrect Answers: Answers 1 and 3: Brief psychotic disorder requires symptoms to be present for < 1 month, and schizophrenia requires the symptoms to be present for at least 6 months. Answer 4-5: Schizoid and schizotypal are cluster A personality disorders. Schizoid individuals have voluntary social withdrawal, are content with social isolation, and have limited emotional expression. Schizotypal have an eccentric appearance and odd beliefs or magical thinking. They do not exhibit frank psychosis.
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