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Diagnosing Schizophrenia (Case Study)

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18 pages
2020/2021 Written for academic year
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University Of Johannesburg (UJ)
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Psychopathology / Abnormal Psychology
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This essay was graded 86% overall. Instructions: Sihle is a 20-year-old African male who is in his second year of university. He has arrived with a close friend. He reports he is seeking treatment as he often hears voices (who he thinks are ancestors) that instruct him to do “bad” things, such as hurt and kill others, and has heard these voices over the last 3 months. He further reports that he feels his flatmate in his residence has a grudge against him is “watching” him, causing him to feel more and more afraid to leave his room. His intense anxiety about this has begun getting in the way of his ability to complete schoolwork, and his friends are concerned – he says they have told him, “you’re not making sense.”. This makes him very angry and at times has become quite aggressive in response to these comments. Furthermore, his friend contests that his flatmate in residence has any obvious grudge against him, but notes he is concerned about Sihle’s refusal to engage in self-care (with a notable deterioration in his personal hygiene). During your consultation, Sihle occasionally laughs abruptly and inappropriately and sometimes stops speaking mid-sentence, looking off in the distance as though he sees or hears something. His beliefs are fixed, and if they are challenged, his tone becomes hostile. In getting collateral information from his family, who are from a rural community, who hold traditional religious beliefs, it is further reported that they were unable to conduct a specific customary ceremony due to financial constraints, which they feel is significant in his presentation of symptoms. In an essay format critically evaluate this case, making sure you address the following issues: 1. What would be your primary diagnosis of Sihle according to the DSM-5 and ICD-10 (don’t use point form)? 2. Are there any other issues that need to be considered regarding potential differential diagnosis? 3. Discuss the specific challenges of diagnosis of this disorder within a South African context. 4. How would you manage this case given the divergent belief systems of the family from the western perspective, with specific regard to management interventions?

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1




Diagnosing Schizophrenia




Kelsey Nairn

Bachelor of Applied Social Science



Psychopathology

Fred Schouwink

9th November 2020

, 2




Table of Contents

Schizophrenia Spectrum Disorder..............................................................................................4

Prevalence and Causes of Schizophrenia...............................................................................4

Gender................................................................................................................................5

Genetics..............................................................................................................................5

Increased Mortality............................................................................................................6

The Case of Sihle.......................................................................................................................6

Schizophreniform Disorder....................................................................................................7

ICD-10 Diagnostic Criteria................................................................................................7

DSM-5 Diagnostic Criteria................................................................................................7

Delusions......................................................................................................................8

Hallucinations.............................................................................................................9

Disorganized thought...................................................................................................9

Disorganized behaviour:............................................................................................10

Negative symptoms....................................................................................................10

Differential diagnosis..............................................................................................11

Prognosis..............................................................................................................11

Schizophrenia in the South African Context............................................................................12

Cultural Differences in Disorders, Symptoms and Pathology.............................................12

Traditional Healers...............................................................................................................13

, 3


Conclusion................................................................................................................................15

Works Cited..............................................................................................................................17

Dear Kelsey..............................................................................................................................17

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