Edward meets the criteria for the following DSM-5 diagnoses.
| Name of the Disorder | ICD-10-CM | Specifier | Severity |
| Paranoid Schizophrenia Spectrum | F20.0 | Delusions
Hallucinations Grossly disorganized Suicidal thoughts Poor hygiene |
severe |
| Persistent depressive disorder | F34.1 | Intermittent major depressive episodes
Aggressive behaviors |
Moderate |
Explanation of diagnosis
Edward meets the first criteria for paranoid schizophrenia spectrum disorder because he experiences delusions or false beliefs that are not based on reality. Sometimes Edward has irrelevant talks and is not coherent. He also experiences auditory hallucinations of an angle’s voice. These hallucinations invoice seeing and hearing things that do not exist yet he had a full force and impact of normal experiences. Edward also appears disorganized. For instance, Edward neglected his hygiene and appeared socially withdrawn. The DSM-5 points out that people with paranoid schizophrenia spectrum disorder also experience suicidal behaviors and thoughts (First, 2014). Edward has a medical history of attempted suicide six weeks ago after injuring his wrist.
Edward also meets the second criteria for persistent depressive disorder for several reasons. First Edward, has a low, dark, and sad mood including feelings of isolation. In the last few weeks, he became socially withdrawn and would spend too much time on the internet. He is also defiant and irritable and angry. His behavior was assessed seem to occur across multiple relationships and more than one setting (friends, hospital, home).
Four diagnoses I initially considered
Antisocial Personality Disorder: I thought Edward had antisocial behavior because he was socially withdrawn. However, due to other associated symptoms, I felt that he does not meet this criterion.
Conduct disorder: Initially, I thought that Edward had conduct disorder but after reading DSM-5’s differential diagnosis portion, I came to understand that conduct disorder has a higher prevalence in the destruction of property and aggression (APA, 2020). This was not displayed in Edward’s symptoms.
Disruptive mood dysregulation disorder: Even though Edward does not meet DSM-5’s criteria for this disorder, I think that other mentioned components in the explanation of ODD diagnosis are missing.
Obsessive-compulsive disorder: I felt that Edward meets this criterion because of his horrific thoughts about harming himself and losing control. He also had unwanted thoughts including aggression and religious subjects. However, this Edward cannot be categorized in this disorder since he does not exhibit other symptoms as mentioned in DSM-5 categories.
Eliminations that could be made in the Neurodevelopmental spectrum
I would not change the diagnoses since neurodevelopment disorders are a group of conditions that appear during the developmental period (APA, 2020).
Edward’s symptoms match most characteristics of paranoid schizophrenia spectrum disorder. He continues to show hallucinations and his behaviors are not focused on goals including resistance to instructions. Nonetheless, there are other negative symptoms such as the reduced ability to functioning normally. Edward’s effective communication ability is impaired and he seems to provide completely unrelated answers. These symptoms were severe to the extent of Edward trying to kill his roommate through suffocation
References
American Psychiatric Association (APA). (2020). Assessment measures. In Diagnostic and statistical manual of mental disorders. Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.AssessmentMeasures
First, M. B. (2014). Handbook of differential diagnosis. Washington, DC: American Psychiatric Association
