Clinical Diagnosis
Scenario 1 – Sarah Sarah is a thirty-eight-year-old woman who has been residing in an in-patient care facility for the last four years. Sarah is very overweight and is extremely inactive. Most days, she spends her time sitting in a chair staring out the window. She tends to sit in a somewhat odd manner, hunched over with her hands clenched tightly in front of her. Although she is often very still and inactive, there are times where Sarah appears physically agitated. When she feels agitated, Sarah will slap at her shoulders in a repetitive fashion. Sarah’s doctors have asked her to participate in group therapy, but she rarely becomes involved. When one of the nurses or an orderly asks Sarah ‘how are you doing today?’ Sarah will respond by quietly repeating the question while starting into the distance. Sarah has not responded well to medication treatments. According to Sarah’s clinical history, her symptoms developed slowly throughout her childhood and adolescence. Sarah came from a large family and she was often quiet and withdrawn throughout her childhood. Sarah’s symptoms worsened during her later teens, ultimately leading her to be institutionalized. She has resided in intuitions and halfway homes ever since. What psychotic disorder best describes Sarah’s symptoms, and why? Scenario 2 – Vince Vince is a nineteen-year-old man who has recently been hospitalized after being arrested by the police on a breaking and entering charge. Vince is extremely agitated and insists that the newscasters from a local television station have been harassing him. Vince states that these newscasters have snuck derogatory statements about him into their broadcast for over the last month. He was arrested after breaking into the home of one of these newscasters, where he planned on leaving a threatening letter. Once Vince is able to calm down and feel more relaxed, he admits that he has been hearing voices for over the last month. These voices seem to come from nowhere and have been maintained an ongoing and very negative commentary about Vince and how he is never going to succeed in life. Vince’s symptoms appeared to come about suddenly. They began approximately seven months ago and progressed rapidly. He has had no prior difficulties with psychosis and had been functioning normally up until the onset of symptoms. Vince reports that he does not do drugs. A toxicology screen shows supports this and shows that there are no illegal drugs in his system. Vince was ultimately prescribed an antipsychotic medication and he responded well to the medication treatment. The voices and his fixation with the newscasters gradually diminished and he was able to re-attain healthy, normative functioning. What psychotic disorder best describes Vince’s symptoms, and why?