Provide one or more DSM diagnosis for the case below. (Specific name(s) and/or s

Question

Provide one or more DSM diagnosis for the case below. (Specific name(s) and/or subtype from the DSM)?

Describe the obervations that support each diagnosis?

Describe any clinical evidence that seems to be inconsistent with the diagnoses (i.e., symptoms that might suggest a different DSM diagnosis other than the one(s) above)?

Case of Sonny - Summary At the time of his admission to a private psychiatric hospital, Sonny Ford was a 24-year old single African-American male who lived with his adoptive parents. Sonny had been referred for hospital admission by his outpatient psychotherapist. Over the past 2 years Sonny had struggled with symptoms such as concentration difficulties, anxiety, and obsessional thinking. More significantly, within the year prior to his admission, Sonny began to experience paranoid and delusional thoughts that had become quite persistent. These difficulties began after Sonny smoked marijuana. While experiencing the effects of marijuana, Sonny believed that his mind had gone "numb." From that time on, Sonny believed that the marijuana had permanently "warped" his brain. He became increasingly distressed and frustrated over his inability to get others to agree that marijuana had this effect on him. More recently, Sonny had developed concerns that the police and FBI were "out to get him." In addition, he had begun to feel that certain television shows had special importance to him and important information was embedded in these programs directed specifically at him. Sonny believed that these messages coming to him through the television were sent to remind him that he was at risk for some sort of plot by the authorities. Sonny also heard voices in his head. Although he could not make out what they were saying, Sonny perceived the voices as "angry" and "critical." Over the past few months, Sonny's symptoms had worsened to the point that they were interfering substantially with his attendance at work as a state office janitor. Because of these factors and the lack of improvement in outpatient counseling, Sonny was referred to this inpatient hospital. At the intake evaluation for his inpatient admission, Sonny's emotions were restricted. Although appearing tense and anxious, Sonny's face was mostly immobile for the duration of the interview. He engaged in very little eye contact ith the interviewer and his body movements were agitated and restless, as evidenced by rocking movements of his legs and body. His speech was hesitant and deliberate, and he often answered the interviewer's questions with brief and empty replies. For example, when the interviewer asked "what difficulties are you having that you would like help for?" Sonny replied, "I think it was the marijuana." Clinical History Sonny was adopted at birth, and no records were available about medical or psychiatric history of his family origin. Sonny was raised in a household of four: in addition to his parents, he had a sister 4 years older who had also been adopted. He could recall very few memories from his early childhood. However, Sonny said that throughout his life he had always been a loner who, to this day, never had any friends. Sonny's parents, who were present at the time of his admission to the hospital, confirmed that Sonny had alw been frustrated by social interactions and added that their son had always been hypertensive to real or perceived criticism during his school years. Sonny was very attached to his father and, for many years, experienced considerable distress and

Explanation / Answer

Ans 1 DSM 5 diagnosis Will be Schizophrenia( subtypes are not part of DSM 5 anymore)

Ans 2 Observations that support the diagnosis

A ) Positive symptoms in the form of

Delusions or persecution : FBI is after him

Delusion of reference : television showing stories about him,special references to him

Hallucinations : voices which were angry amd critical

B) Negative symptoms of :

Poverty of speech : less spontaneous speech, small sentences

Asocialty : wants to stay alone

C) Duration of symptoms being at least an year prior to this admission.

Ans 3 A possible differential diagnosis could include Cannabis Use disorder with Cannabis induces psychotic disorder or Schizotypal personality disorder.

Since he has been abusing cannabis which can cause psychosis itself or trigger Schizophrenia in predisposed individuals it is important to keep this in mind.

Schizotypal personality disorder could be there in background as he has been

1 asocial - doesn't have any friends

2 hypersentive to real or perceived criticism

3 harboring odd beleifs like contracting HIV, marijuana warping his brain

4 all these diffculties have onset during chilhood or adolscene

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