Question

Provide a diagnosis for the following cases. Make sure you say why you chose that diagnosis by noting the specific behaviors described in the case.

The Case of Matthew Boudreaux               Matthew, a 25-year-old single man, was admitted to a large metropolitan hospital’s mental health service. He was not verbal and offered no chief complaint on admission. Matt’s older cousin, Lonny Pasquale, brought him to the hospital and offered that “Matt is going crazy again. He probably needs to go back to the state hospital. He’s been in an out of that hospital several times in the past 3 or 4 years. They give him medicine, but I’m sure he doesn’t take it when he leaves the hospital.”Lonny described his cousin. “Matt always talked funny, even when he was 10 or 12 years old. He heard and saw things that nobody else did and frequently insisted he had special powers no one else had.” There is no evidence that Matt had ever been gainfully employed, and Lonny said nothing about any type of friendships that Matt had.Lonny practically had to carry Matt into the hospital—Matt would only walk on the outside arches of his feet, and he refused to be moved. The psychiatrist’s notes describe Matt’s appearance as that of a slightly built, disheveled young man who paid no attention to his current surroundings. During their initial meeting, he sat with his eyes shut tight, did not look up when spoken to, and did not answer questions directed to him. Matt refused to participate in a conversation with the psychiatrist and did not answer questions. Although it appeared that Matt understood things happening around him, he did not interact with anyone. He sporadically introduced phrases he had apparently heard before into his speech, and he accomplished this without opening his eyes or looking up. His speech was affected so that he sounded like a babbling child—he often spoke with a lisp or stammer, and occasionally burst forth with a fragment of a song. Matt made many facial grimaces and performed various other kinds of seemingly senseless physical movements. For example, he crossed his legs rigidly so that they were “assembled” in odd positions while his hands were in constant motion on top of his head.

Answer 1

Diagnosis to Matthew's case is: SCHIZOPHRENIA. This is a chronic illness which requires active symptoms for >1 month for at least 6 months and one of the first three symptoms for diagnosis. His features correlate with many symptoms of the disorder and include:

1. Disorganized Speech: sounding like a child, randomly signing a song during examination.
2. Hallucinations: past history of seeing things when no one else did.
3. 'Delusions: claiming he has special power since he was a child.
4. Catatonia: unusual physical movements like crossing his legs and moving his hands on top of his head.
5. Negative Symptoms: defined as blunt affect (unable to display emotions): doesn't pay much attention to his surrounding environment or the psychiatrist, social withdrawal: He doesn't have any friends. apathy (lack of concern)/ anhedonia (loss of interest): Matthew didn't respond when spoken to, refused to answer questions and converse with the psychiatrist, doesn't interact with anyone.
6. Functional Impairment: disheveled young man, has no job, unable to walk- had to be carried by his cousin.