Diagnosis of Schizophrenia Spectrum and Other Psychotic Disorders
This week, you have focused on key symptoms related to schizophrenia spectrum and other psychotic disorders. Now, in this Assignment, you practice diagnosing in this area.
This is your fifth practice in diagnosing mental disorders. When reviewing the case study, remember that social workers keep a wide focus on several potential syndromes, analyzing patterns of symptoms, risks, and environmental factors. Narrowing down from that wider focus happens naturally as you match the individual symptoms, behaviors, and risk factors against criteria and other information in the DSM-5-TR.
Here are a few tips or reminders:
• Catatonia is a specifier, although it does have a code. It even appears on a line of its own and may look like a code. However, it cannot be used as a diagnosis on its own.
• Remember to include all of the words that go with the diagnostic code.
Note: Remember that symptoms can occur in many disorders. As a result, all disorders in the DSM-5-TR covered up until this point may factor into your diagnosis (for example, as a possible additional disorder you diagnose).
To Prepare
• Review the case study for this week.
• Start by familiarizing yourself with the disorders from the DSM-5-TR found in the Learning Resources this Week.
o Look within the noted sections for symptoms, behaviors, or other features the client presents within the case study.
• If some of the symptoms in the case study cause you to suspect an additional disorder, then research any of the previous disorders covered so far in the course.
o This mirrors real social work practice where you follow the symptoms.
• Review the correct format for how to write the diagnosis noted below. Be sure to use this format.
o Remember: When using Z codes, stay focused on the psychosocial and environmental impact on the client within the last 12 months.
By Day 7
Submit your diagnosis for the client in the case. Follow the guidelines below.
• The diagnosis should appear on one line in the following order.
Note: Do not include the plus sign in your diagnosis. Instead, write the indicated items next to each other.
Code + Name + Specifier (appears on its own first line)
Z code (appears on its own line next with its name written next to the code)
Then, in 1–2 pages, respond to the following:
• Explain how you support the diagnosis by specifically identifying the criteria from the case study.
o Describe in detail how the client’s symptoms match up with the specific diagnostic criteria for the disorder (or all the disorders) that you finally selected for the client. You do not need to repeat the diagnostic code in the explanation.
• Identify the differential diagnosis you considered.
• Explain why you excluded this diagnosis/diagnoses.
• Explain the specific factors of culture that are or may be relevant to the case and the diagnosis, which may include the cultural concepts of distress.
• Explain why you chose the Z codes you have for this client.
Sample Solution
After reviewing the case of J.D., a 37-year-old white male who is living with his mother and suffering from delusions, hallucinations, disorganized thoughts and behavior, it appears that he may be suffering from Schizophrenia Spectrum and Other Psychotic Disorders as outlined in the DSM-5-TR (APA, 2013). The diagnostic criteria for this disorder include positive symptoms such as delusions, hallucinations or disorganized speech; negative symptoms such as absence or reduced expression of emotions; cognitive deficits involving poor ability to focus; impairment in functioning due to these experiences; and evidence that these issues cannot be explained by another mental health issue or environmental factor (APA, 2013).
J.D.’s presentation demonstrates many signs of this diagnosis including auditory hallucinations where he reports hearing voices telling him to do things he does not want to do. He also suffers from paranoid delusions which centers around his fear that someone is out to get him and believes there are malicious forces at work manipulating his thoughts. Furthermore J.D.’s reported disorganized thought process is demonstrated through the disruption in communication when talking about multiple topics simultaneously without making sense (Hoffman et al., 2018). His impaired functioning due to all these symptoms further suggests schizophrenia spectrum disorder as he has difficulty maintaining employment and social relationships due to his behavior (Stahl & Stahl, 2016). Additionally, all these issues cannot be accounted for by substance abuse or other factors making this a more likely diagnosis.
In conclusion, J.D.’s history provides enough evidence indicating schizophrenia spectrum disorder thus matching most of the criteria set out by DSM-5 – TR.. Therefore an appropriate treatment plan can now be designed targeting symptom management alongside relapse prevention techniques so that J.D’s quality of life can improve over time.
