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Rationale (what did you see that supports the diagnosis?)
A client is a 50-year-old female who lives with her husband and claims that she does some research. From her behavior, it is seen that she is hyperactive and is hardly paying attention to what is told to her concentrating only on her thoughts and feelings. The client’s husband made her go to a counselor for the recommendations regarding her condition. Other symptoms include talking too much, changing topics in a conversation, distracting, having thoughts of being followed by the CIA, and having conversations with god.
Thus, she is probably has Delusional Disorder according to the following criteria. Criterion A: the client claims that many people want to have sex with her, which is the main symptom of the delusional disorder of erotomanic type. Criterion B: the client states that she has a special relationship with god and has the secret of the universe. She also thinks that many people want to write a book about her, as she thinks that she is brilliant. All these symptoms are peculiar to the delusional disorder of grandiose type. Criterion C: the client feels that the CIA has framed her and stolen her thoughts. In addition, she claims that doctors are bad, as they have given her medications that she did not like. These symptoms are peculiar to the delusional disorder of persecutory type.
Developmental Disorder(s): F22.0 Delusional disorder, mixed type
Rationale (what did you see that supports the diagnosis?)
The client has been probably having Delusional Disorder since her childhood but in a milder form. According to her husband, she was treated in a psychiatric hospital when she was a teenager. He also says that she had been there three times before the age of eighteen. Evidently, she was cured at that time, and her condition has been normal until recently.
Personality Disorder(s): Schizotypal Personality Disorder
Rationale (what did you see that supports the diagnosis?)
The main symptom that characterizes Schizotypal Personality Disorder is the distortion of events that happen in reality. Thus, the client claims that she is the smartest and the most brilliant person, that she has the cure for cancer, that leaves are speaking and singing songs to her, that Google is talking to her, and that she spoke with the Pope.
Medical Disorder(s): No diagnosis
Rationale (what did you see that supports the diagnosis?)
There are no particular diseases mentioned in the client’s medical history.
Client Strengths
- The client has no medical disorders.
- The client has a family that looks after her.
- The client does not abuse any substances.
- The client has lived for a long time without her disorder meaning that it can be treated once again.
- The client loves her husband though she thinks that he is not smart enough.
- The client regularly visits a counselor though she does not like these sessions.
- The client has a lot of energy.
- The client listens to her husband, which makes it easier to make her begin the treatment.
Comments/Differential Diagnosis. (Did you consider any other possible diagnoses? Identify them here, and discuss your rationale for not selecting them. You can also use this section to discuss additional observations which helped you with your diagnostic decision making.
Due to the abundance of symptoms the client has, it is possible to think that she has some another illness. Thus, one of the possible diagnoses is Paranoid Personality Disorder. The main symptoms of this disorder that the client has are the suspiciousness and concerns about the conspiracy against her. However, this disorder also includes such symptoms as sensitivity and bearing grudges which are not reported by the client. Another possible diagnosis is schizophrenia.
In this respect, the client expresses unusual beliefs with a great force, has thought and mood disorders, and has a distorted perception of reality (“Mental Health,” 2016). Regarding schizophrenia, a patient usually has severe hallucinations that can completely separate them from reality and cannot act normally. Therefore, the client does not fit these criteria either.
Reference
Mental Health and Delusional Disorder. (2016). Web.
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