Make sure you indicate in your write-up how each piece of information in the case is an example of the criteria in the DSM so that you can justify your diagnosis.  Be sure to list and COPY the exact criterion from DSM,and following each criterion, list the relevant symptoms or history that corresponds to it. DO NOT GENERALIZE BY SIMPLY LISTING SXS WITHOUT ALIGNING THEM WITH EACH DSM-5 CRITERION. The next section will require you to offer “rule out” diagnoses.  These are possible diagnoses that “could” be true, but after careful analysis do not meet ALL OF THE CRITERIA necessary to make that diagnosis.  A medical example:  a patient complains of a severe headache, stiff neck and a high temperature.  You may suspect meningitis….that would be a “rule out” that requires further investigation.  Clearly, it is a possible diagnosis, but when a spinal tap is done, it is negative and meningitis is “ruled out.”  It was the flu!  When you give me two rule outs for the case make sure each one is plausible.  For instance, if your final diagnosis turns out to be schizophrenia, a rule out of a phobia for elevators is  not even close to the symptoms of schizophrenia and would never be considered a possibility. You must describe why each of your rule outs DO NOT describe the patient by noting and listing the exact DSM criteria that are NOT met and WHY.   Once again, you must List the exact DSM criteria that are not met. As you read about disorders you will see that their are clusters or categories of somewhat similar disorders that can be differentiated from one another.  Finally, you will be asked to discuss treatment options for your diagnoses and the prognosis for the patient, that is what is the likely outcome and possibility for improvement or deterioration. Remember, all reports must be at least 1 full page, single spaced 12 point font. 

Ms. Neighbors

Ms. Neighbors is a 25 year old, single, unemployed African American woman who was evaluated in the crisis center after her sister observed that her behavior had become increasingly bizarre and her work habits erratic.  She had no prior psychiatric history.

Ms. Neighbors lost her job 3 months ago and had become increasingly preoccupied with her neighbors who she felt were harassing her by “accessing” her thoughts and then repeating them to her.  She admitted to feeling “stressed” since she lost her job.

She presented as poised, attractive and appeared perfectly normal which surprised her evaluators after they had read her admission complaints.  She had no insight as to why she was being evaluated.  She denied mood disturbance and denied having any psychotic symptoms.  When asked if anyone could read her mind, she replied, “Yes, it happens all the time,” and described how when she was planning her dinner in silence, she heard her neighbors reciting her menu out on the street.  She claimed that everyone developed telepathic powers in childhood and she had just become aware of hers.  She was also upset that her neighbors were critical of her and saying that “You’re no good” and “You have to leave.”  She admitted to thinking about having a “contract” put out to “eliminate” the neighbors.

The patient was medicated and her beliefs about thought broadcasting remitted.  Within 2 months she was employed and feeling well.

Questions:

1. What is her diagnosis?
2. What are the symptoms that helped you make this diagnosis?  What diagnostic criteria do they relate to?
3. What are two other possible diagnoses and why did you not choose them?
4. Discuss the role of genetics in this case.
5. What is her prognosis?