Schizophrenia (first episode) — MCCQE Part 1 MCQ

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EasyPsychosisSchizophrenia (first episode)MCCQE Part 1

A 24-year-old woman has three months of persecutory delusions, thought broadcasting, auditory hallucinations, social withdrawal and markedly impaired self-care. There has been no major mood episode, substance exposure or medical cause, and she previously functioned well. Which diagnosis best fits the current duration of illness?

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Correct answer: D — Schizophreniform disorder

Schizophreniform disorder is the best diagnosis because the patient has characteristic schizophrenia-spectrum symptoms with functional deterioration lasting three months. CAMH defines schizophreniform disorder as schizophrenia-like illness lasting at least one month but less than six months. Schizophrenia requires continuous signs for at least six months, so it cannot yet be diagnosed from the stated course. Brief psychotic disorder lasts less than one month. Delusional disorder does not account for prominent hallucinations, thought broadcasting and marked functional decline. Schizoaffective disorder requires a major mood episode during the illness as well as a period of psychosis without prominent mood symptoms; no mood episode is described. The diagnosis should be reassessed longitudinally because persistence beyond six months may establish schizophrenia.

Reference: Centre for Addiction and Mental Health, Psychosis: Diagnosis, https://www.camh.ca/en/professionals/treating-conditions-and-disorders/psychosis/psychosis---diagnosis