Schizophrenia Q 36
A woman is admitted to the psychiatric emergency department. Her significant other reports that she has difficulty sleeping, has poor judgment, and is incoherent at times. The client’s speech is rapid and loose. She reports being a special messenger from the Messiah. She has a history of depressed mood for which she has been taking an antidepressant. The nurse suspects which diagnosis?
A. Schizophrenia
B. Paranoid personality
C. Bipolar illness
D. Obsessive-compulsive disorder (OCD)
Correct Answer: C. Bipolar illness
Bipolar illness is characterized by mood swings from profound depression to elation and euphoria. Delusions of grandeur along with pressured speech are common symptoms of mania. 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 A: Schizophrenia doesn’t exhibit mood swings from depression to euphoria. Derived from the Greek ‘schizo’ (splitting) and ‘phren’ (mind) with the term first coined by Eugen Bleuler in 1908, schizophrenia is a functional psychotic disorder characterized by the presence of delusional beliefs, hallucinations, and disturbances in thought, perception, and behavior. 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.
Option B: Paranoia is characterized by unrealistic suspiciousness and is often accompanied by grandiosity. Paranoia is a pattern of thinking that leads to irrational mistrust and suspicion of other people. It can range from mild feelings of discomfort to an intense, extremely distressing pattern of thinking that indicates a person’s mental well-being is at serious risk.
Option D: OCD is a preoccupation with rituals and rules. Obsessive-compulsive disorder (OCD) is often a disabling condition consisting of bothersome intrusive thoughts that elicit a feeling of discomfort. To reduce the anxiety and distress associated with these thoughts, the patient may employ compulsions or rituals. These rituals may be personal and private, or they may involve others to participate; the rituals are to compensate for the ego-dystonic feelings of the obsessional thoughts and can cause a significant decline in function.