Assignment: Assessing and Diagnosing Patients With Schizophrenia, Other Psychotic Disorders, and Medication-Induced Movement Disorders
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Psychotic disorders and schizophrenia are some of the most complicated and challenging diagnoses in the DSM. The symptoms of psychotic disorders may appear quite vivid in some patients; with others, symptoms may be barely observable. Additionally, symptoms may overlap among disorders. For example, specific symptoms, such as neurocognitive impairments, social problems, and illusions may exist in patients with schizophrenia but are also contributing symptoms for other psychotic disorders.
For this Assignment, you will analyze a case study related to schizophrenia, another psychotic disorder, or a medication-induced movement disorder.
To Prepare:
Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing psychotic disorders. Consider whether experiences of psychosis-related symptoms are always indicative of a diagnosis of schizophrenia. Think about alternative diagnoses for psychosis-related symptoms.
Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Identify at least three possible differential diagnoses for the patient.
By Day 7 of Week 7
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
Expert Solution Preview
Introduction:
Assessing and diagnosing patients with schizophrenia, other psychotic disorders, and medication-induced movement disorders is a challenging task that requires a thorough understanding of psychiatric evaluation and diagnosis. In this assignment, students are required to analyze a specific case study, gather patient history, ask relevant interview questions, and consider possible differential diagnoses. Students will then use the gathered information to complete a comprehensive psychiatric evaluation using a given template, which includes a differential diagnosis and a critical-thinking process to formulate the primary diagnosis.
Answer:
The patient’s history is an essential tool in diagnosing psychotic disorders. Therefore, to collect necessary information from the patient in this specific case study, I would ask about their family, medical, and psychiatric history. It is important to know whether the patient has a family history of any psychiatric disorder, any medical history or physical illnesses that they are experiencing or have experienced in the past, and any previous psychiatric diagnoses or treatments. Additionally, I would ask about the onset of the symptoms, their duration, severity, and how they manifest in the patient’s life.
Considering this case study, I would begin by asking the patient about their chief complaint and symptoms. Some of the interview questions I would ask include:
– When did you start experiencing the symptoms?
– What symptoms are you currently experiencing?
– Are your symptoms severe or mild?
– Do you experience any delusions, hallucinations, or disordered thinking?
– Are there any specific triggers or situations that worsen your symptoms?
– Have you ever experienced similar symptoms in the past?
– Are you currently taking any medications or have you taken any medication in the past?
Based on the patient’s symptoms and history, I would consider at least three possible differential diagnoses, which include schizophrenia, schizoaffective disorder, and substance-induced psychotic disorder.
In order to determine an accurate diagnosis, I would compare the patient’s symptoms to the DSM-5 diagnostic criteria for each differential diagnosis. I would then explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. The critical-thinking process that led me to the primary diagnosis would involve analyzing the patient’s positive and negative symptoms, the duration and severity of their symptoms, and their impact on their functioning in life. I would also consider the patient’s medical and psychiatric history, as well as their medication use.
In reflection, if I could conduct the session with this patient again, I would take into consideration legal and ethical considerations related to confidentiality and informed consent. Additionally, I would consider patient factors such as age, ethnic group, and socioeconomic status when discussing health promotion and disease prevention. Furthermore, I would consider any risk factors that could impact the patient’s psychiatric diagnosis, such as cultural background or PMH.
