Comprehensive exams for Mental Health Q 84
A man is brought to the hospital by his wife, who states that for the past week her husband has refused all meals and accused her of trying to poison him. During the initial interview, the client’s speech, only partly comprehensible, reveals that his thoughts are controlled by delusions that he is possessed by the devil. The physician diagnoses paranoid schizophrenia. Schizophrenia is best described as a disorder characterized by:
A. Disturbed relationships related to an inability to communicate and think clearly.
B. Severe mood swings and periods of low to high activity.
C. Multiple personalities, one of which is more destructive than the others.
D. Auditory and tactile hallucinations.
Correct Answer: A. Disturbed relationships related to an inability to communicate and think clearly.
Schizophrenia is best described as one of a group of psychotic reactions characterized by disturbed relationships with others and an inability to communicate and think clearly. Schizophrenic thoughts, feelings, and behavior commonly are evidenced by withdrawal, fluctuating moods, disordered thinking, and regressive tendencies. Traditionally, symptoms have divided into two main categories: positive symptoms which include hallucinations, delusions, and formal thought disorders, and negative symptoms such as anhedonia, poverty of speech, and lack of motivation. The diagnosis of schizophrenia is clinical; made exclusively after obtaining a full psychiatric history and excluding other causes of psychosis.
Option B: Severe mood swings and periods of low to high activity are typical of bipolar disorder. The bipolar affective disorder is a chronic and complex disorder of mood that is characterized by a combination of manic (bipolar mania), hypomanic and depressive (bipolar depression) episodes, with substantial subsyndromal symptoms that commonly present between major mood episodes.
Option C: Multiple personality, sometimes confused with schizophrenia, is a dissociative personality disorder, not a psychotic illness. Dissociative identity disorder (DID) was formerly called multiple personality disorder. People with DID develop one or more alternate personalities that function with or without the awareness of the person’s usual personality. DID is one of a group of conditions called dissociative disorders. Dissociative disorders are mental illnesses that involve disruptions or breakdowns of memory, consciousness or awareness, identity and/or perception — mental functions that normally work smoothly.
Option D: Many schizophrenic clients have auditory hallucinations; tactile hallucinations are more common in organic or toxic disorders. Auditory hallucinations are the sensory perceptions of hearing voices without an external stimulus. This symptom is particularly associated with schizophrenia and related psychotic disorders but is not specific to it. These voices can be stressful when they are threatening, derogatory, commanding, or haunting, affecting the social and occupational functioning of an individual. They can be distressing to families and friends.