Page 1 of 4: Psychiatry- Anxiety or adjustment disorder ???????

Maggi25 · Credits: 2408 My Scrapbook

A 16 yr old boy does not attend school b'coz of the fear of being harmed by schoolmates. He thinks that his classmates laugh at & talk about him. He is even scared of going out to the market. He is most likely suffering from :
a) Anxiety neurosis
b) Manic depressive psychosis
c) adjustment reaction
d) Schizophrenia

This ques came in all india 2004. Mudit Kanna gives the ans. as Schizophrenia.

Why can't it simply be anxiety or an adjustment disorder?
Also, if no options were given or assuming all options to be wrong, what would be the likely diagnosis?

confused · Credits: 3655 My Scrapbook

i agree, it could be an anxiety disorder.
its not even clear if it is delusion, forget about calling it schizophrenia (where one persecutory delusion is not enough).

decembermist · Credits: 41021 My Scrapbook

why not an adjustment reaction

gandalf · Credits: 8355 My Scrapbook

misty, adjustment to wat?!!!

Maggi25 · Credits: 2408 My Scrapbook

Hey guys, thanx for responding but can't u hold a debate and discuss the answer. Give your reasons atleast.

shraddha · Credits: 19580 My Scrapbook

i think the answer should be schizophrenia becoz

he has delusion of reference//hallucination?
social withdrawl negative symptoms

adjustment disorder at school at 16 yrs. in unlikely??unless he has changed the school recently....

anxiety won't make him FEARr from his friends

pl. correct me if i am wrong

Maggi25 · Credits: 2408 My Scrapbook

Hi Shraddha, maybe u r right. But don't u think the info is insufficient to diagnose schizophrenia. Also, if no options were given, would u call it social phobia??

confused · Credits: 3655 My Scrapbook

A 16 yr old boy does not attend school b'coz of the fear of being harmed by schoolmates( POSSIBLE DELUSION, POSSIBLE ANXIETY- RAGGING, [bleep] ETC). He thinks that his classmates laugh at & talk about him(POSSIBLE DELUSION, POSSIBLE ANXIETY AGAIN). He is even scared of going out to the market(POSSIBLE DELUSION, SOCIAL PHOBIA/AGORAPHOBIA). He is most likely suffering from

Schizophrenia::
dear shraddha,
where is the hallucination in this case??
the only case for schizophrenia here is multiple delusions(not of the schizophrenia type-control, bizarre etc). there is nothing mentioned about self care, negative symptoms, cognitive symptoms, catatonic symptoms etc

Agoraphobia::
marked and consistently manifest fear in or avoidance of atleast two of the following situations: crowds, public places, travelling alone, or travelling away from home. this needs to accompanied by a couple of symptoms like sweating, palpitations, chest pain, fear of dying, etc etc.
the first part of it holds good to make a diagnosis. only the second part needs to be fulfilled.

Adjustment disorder:
there is no stressful event mentioned in teh case. so adjustment to what?? new school?

MDP::
no history of mania, no clear depressive symptoms

confused · Credits: 3655 My Scrapbook

further debate?

confused · Credits: 3655 My Scrapbook

Two more point in favour of schizophrenia is the age of onset and sex.

AGORAPHOBIA:(definition from kaplan and sadock) Morbid fear of open places or leaving the familiar setting of the home. May be present with or without panic attacks. the case fits this, with one point against it being sex. its more common in female.

chose any guys, any conclusion: i think i would skip the question as a first choice. as a second choice go for schizophrenia( i changed my mind). and as a third for anxiety neurosis.

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