CHAPTER 13: CASE STUDIES
Case Study: John - Schizophreniform Disorder
Introduction:
This case study examines the presentation and symptoms of John, a 26-year-old male
who meets the criteria for Schizophreniform Disorder according to the DSM-5. John's
experiences provide real-life examples of how the disorder manifests in an individual's
life.
Background Information:
John is a university student studying computer science. He has no significant
psychiatric history and has always been perceived as a high-functioning individual.
However, over the past six months, John's friends and family noticed a significant
change in his behavior and emotional state.
Symptom 1: Delusions
John develops grandiose delusions, believing he is a genius inventor who can
communicate with extra-terrestrial beings. He spends hours writing complex
mathematical equations on his walls, claiming they are messages from aliens. He
starts posting his theories on social media, convinced that he has discovered the
secrets of the universe.
Symptom 2: Hallucinations
John begins experiencing auditory hallucinations, hearing voices that are not present.
He believes these voices belong to the extra-terrestrial beings he communicates with.
He reports hearing them whispering about his future as a chosen leader who will save
humanity. He becomes increasingly preoccupied with deciphering their messages.
Symptom 3: Disorganized Speech
John's speech becomes disorganized and incoherent. During conversations, he rapidly
jumps from one topic to another, making it difficult for others to follow his train of
thought. His speech is littered with neologisms, using words or phrases that have no
meaning to others. He often interrupts others, speaking loudly to ensure his messages
are heard.
Symptom 4: Negative Symptoms
John experiences a decline in his overall functioning and motivation. He neglects his
personal hygiene, forgets to eat regularly, and starts missing classes. He withdraws
socially, spending most of his time alone, absorbed in his delusional world. He
becomes emotionally detached, displaying a flat affect and reduced emotional
responsiveness.
Symptom 5: Disorganized Behavior
John's behavior becomes increasingly erratic and disorganized. He starts wearing
mismatched clothes and stops following a daily routine. He exhibits odd motor
mannerisms, such as repetitive hand movements and pacing back and forth. He
appears oblivious to social norms and engages in inappropriate behaviors, such as
talking loudly to himself in public.
,Case Study: John - Schizoaffective Disorder
Introduction:
John is a 32-year-old man who has been struggling with a complex mental health
condition known as schizoaffective disorder. He exhibits symptoms that align with the
criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth
Edition (DSM-5) for this disorder. Through various real-life examples, we will explore
how John's symptoms have manifested and impacted his daily life.
Diagnostic Criteria:
1. Schizophrenia symptoms:
a) Delusions:
Example: John firmly believes that he is being followed by government agents who
want to harm him. He often talks about their surveillance methods and elaborate
conspiracies targeting him.
b) Hallucinations:
Example: John frequently hears voices that are not audible to others. These voices
often command him to engage in harmful or self-destructive behaviors, causing
significant distress.
2. Mood disorder symptoms:
a) Major depressive episodes:
Example: John experiences periods of intense sadness, loss of interest in previously
enjoyed activities, low energy, and significant changes in appetite and sleep patterns.
During these episodes, he isolates himself from friends and family.
b) Manic episodes:
Example: There are times when John exhibits elevated mood, increased energy,
racing thoughts, and grandiose ideas. During these episodes, he engages in impulsive
behaviors, such as excessive spending or risky ventures.
3. Duration:
John experiences these symptoms for a continuous period of at least two weeks,
and they cause significant impairment in his social, occupational, and personal
functioning.
4. Exclusion:
Symptoms cannot be better explained by substance abuse, medication side effects,
or another medical condition.
Case Study: Delusional Disorder
Patient Information:
Name: John Doe
Age: 45
Occupation: Sales Representative
Background: Married with two children, no history of psychiatric disorders.
Presenting Complaint:
, John Doe presents with a persistent belief that his colleagues at work are conspiring
against him, trying to sabotage his career and reputation.
Diagnostic Criteria:
According to the DSM-5, Delusional Disorder is characterized by the presence of one
or more delusions lasting for at least one month. Delusions are false beliefs that are
not based on reality and are not culturally accepted. The delusions must not be due to
the effects of substance abuse, a medical condition, or another mental disorder.
Symptoms and Manifestations:
1. Non-bizarre delusions: John firmly believes that his colleagues are intentionally
plotting to ruin his career. He is convinced that they are spreading false rumours about
him to the management and clients. He interprets ordinary office conversations and
interactions as evidence of their malicious intent. For example, when a co-worker
politely declines his offer to go out for lunch, he believes it's because they want to
avoid being seen with him to maintain the illusion of their camaraderie.
2. Functioning not markedly impaired: Although John's delusion causes distress and
preoccupies his thoughts, he continues to perform his job responsibilities adequately.
He maintains a good sales record and is punctual, but his interactions with colleagues
have become strained due to his suspicious behavior. He often avoids team meetings
and social gatherings, fearing they are planned strategies against him.
3. Absence of other prominent psychotic symptoms: John does not exhibit
hallucinations, disorganized speech, or grossly disorganized or catatonic behavior. His
delusion is the primary symptom and does not meet the criteria for another mental
disorder.
4. Duration of at least one month: John has experienced his delusion of conspiracy
for the past six months. Despite evidence to the contrary, such as receiving positive
feedback from clients and superiors, he remains convinced of his colleagues' covert
plans against him.
5. Absence of substance abuse or medical condition: There is no evidence of drug
or alcohol abuse, and medical evaluations have ruled out any underlying physical
condition that could explain the delusion.
Treatment:
John's case requires a comprehensive approach involving therapy and medication.
Cognitive-behavioural therapy (CBT) may be beneficial in helping him challenge and
modify his delusional beliefs. A therapist can work with him to develop strategies for
evaluating evidence and reality-testing his thoughts. Antipsychotic medication may
also be prescribed to alleviate symptoms and improve his overall functioning.
CHAPTER 12: CASE STUDIES
Case Study: John - Paranoid Personality Disorder
Case Study: John - Schizophreniform Disorder
Introduction:
This case study examines the presentation and symptoms of John, a 26-year-old male
who meets the criteria for Schizophreniform Disorder according to the DSM-5. John's
experiences provide real-life examples of how the disorder manifests in an individual's
life.
Background Information:
John is a university student studying computer science. He has no significant
psychiatric history and has always been perceived as a high-functioning individual.
However, over the past six months, John's friends and family noticed a significant
change in his behavior and emotional state.
Symptom 1: Delusions
John develops grandiose delusions, believing he is a genius inventor who can
communicate with extra-terrestrial beings. He spends hours writing complex
mathematical equations on his walls, claiming they are messages from aliens. He
starts posting his theories on social media, convinced that he has discovered the
secrets of the universe.
Symptom 2: Hallucinations
John begins experiencing auditory hallucinations, hearing voices that are not present.
He believes these voices belong to the extra-terrestrial beings he communicates with.
He reports hearing them whispering about his future as a chosen leader who will save
humanity. He becomes increasingly preoccupied with deciphering their messages.
Symptom 3: Disorganized Speech
John's speech becomes disorganized and incoherent. During conversations, he rapidly
jumps from one topic to another, making it difficult for others to follow his train of
thought. His speech is littered with neologisms, using words or phrases that have no
meaning to others. He often interrupts others, speaking loudly to ensure his messages
are heard.
Symptom 4: Negative Symptoms
John experiences a decline in his overall functioning and motivation. He neglects his
personal hygiene, forgets to eat regularly, and starts missing classes. He withdraws
socially, spending most of his time alone, absorbed in his delusional world. He
becomes emotionally detached, displaying a flat affect and reduced emotional
responsiveness.
Symptom 5: Disorganized Behavior
John's behavior becomes increasingly erratic and disorganized. He starts wearing
mismatched clothes and stops following a daily routine. He exhibits odd motor
mannerisms, such as repetitive hand movements and pacing back and forth. He
appears oblivious to social norms and engages in inappropriate behaviors, such as
talking loudly to himself in public.
,Case Study: John - Schizoaffective Disorder
Introduction:
John is a 32-year-old man who has been struggling with a complex mental health
condition known as schizoaffective disorder. He exhibits symptoms that align with the
criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth
Edition (DSM-5) for this disorder. Through various real-life examples, we will explore
how John's symptoms have manifested and impacted his daily life.
Diagnostic Criteria:
1. Schizophrenia symptoms:
a) Delusions:
Example: John firmly believes that he is being followed by government agents who
want to harm him. He often talks about their surveillance methods and elaborate
conspiracies targeting him.
b) Hallucinations:
Example: John frequently hears voices that are not audible to others. These voices
often command him to engage in harmful or self-destructive behaviors, causing
significant distress.
2. Mood disorder symptoms:
a) Major depressive episodes:
Example: John experiences periods of intense sadness, loss of interest in previously
enjoyed activities, low energy, and significant changes in appetite and sleep patterns.
During these episodes, he isolates himself from friends and family.
b) Manic episodes:
Example: There are times when John exhibits elevated mood, increased energy,
racing thoughts, and grandiose ideas. During these episodes, he engages in impulsive
behaviors, such as excessive spending or risky ventures.
3. Duration:
John experiences these symptoms for a continuous period of at least two weeks,
and they cause significant impairment in his social, occupational, and personal
functioning.
4. Exclusion:
Symptoms cannot be better explained by substance abuse, medication side effects,
or another medical condition.
Case Study: Delusional Disorder
Patient Information:
Name: John Doe
Age: 45
Occupation: Sales Representative
Background: Married with two children, no history of psychiatric disorders.
Presenting Complaint:
, John Doe presents with a persistent belief that his colleagues at work are conspiring
against him, trying to sabotage his career and reputation.
Diagnostic Criteria:
According to the DSM-5, Delusional Disorder is characterized by the presence of one
or more delusions lasting for at least one month. Delusions are false beliefs that are
not based on reality and are not culturally accepted. The delusions must not be due to
the effects of substance abuse, a medical condition, or another mental disorder.
Symptoms and Manifestations:
1. Non-bizarre delusions: John firmly believes that his colleagues are intentionally
plotting to ruin his career. He is convinced that they are spreading false rumours about
him to the management and clients. He interprets ordinary office conversations and
interactions as evidence of their malicious intent. For example, when a co-worker
politely declines his offer to go out for lunch, he believes it's because they want to
avoid being seen with him to maintain the illusion of their camaraderie.
2. Functioning not markedly impaired: Although John's delusion causes distress and
preoccupies his thoughts, he continues to perform his job responsibilities adequately.
He maintains a good sales record and is punctual, but his interactions with colleagues
have become strained due to his suspicious behavior. He often avoids team meetings
and social gatherings, fearing they are planned strategies against him.
3. Absence of other prominent psychotic symptoms: John does not exhibit
hallucinations, disorganized speech, or grossly disorganized or catatonic behavior. His
delusion is the primary symptom and does not meet the criteria for another mental
disorder.
4. Duration of at least one month: John has experienced his delusion of conspiracy
for the past six months. Despite evidence to the contrary, such as receiving positive
feedback from clients and superiors, he remains convinced of his colleagues' covert
plans against him.
5. Absence of substance abuse or medical condition: There is no evidence of drug
or alcohol abuse, and medical evaluations have ruled out any underlying physical
condition that could explain the delusion.
Treatment:
John's case requires a comprehensive approach involving therapy and medication.
Cognitive-behavioural therapy (CBT) may be beneficial in helping him challenge and
modify his delusional beliefs. A therapist can work with him to develop strategies for
evaluating evidence and reality-testing his thoughts. Antipsychotic medication may
also be prescribed to alleviate symptoms and improve his overall functioning.
CHAPTER 12: CASE STUDIES
Case Study: John - Paranoid Personality Disorder
