Problem 9 - Abnormal Psychology: An Integrative Approach

Question

Diagnose the type of psychotic disorders described in each of the following. Choose from (a) schizophreniform disorder, (b) schizoaffective disorder, (c) delusional disorder, and (d) shared psychotic disorder. Elias believes the government is out to get him. He thinks agents follow him daily, monitor his calls, and read his mail. His roommate Cedric tried to convince him otherwise. After a year of this, however, Cedric began to believe Elias was correct and the government was out to get him, too.____________

Step-by-Step Solution

Answer

Shared psychotic disorder (d)

Step 1: Analyze Elias's Symptoms

Elias has persistent beliefs that the government is monitoring him closely with no mention of mood disorder, hallucinations, or negative symptoms. This indicates a fixed delusional belief.

Step 2: Examine Duration of Symptoms

The delusions have been consistent over a year without a change indicating a chronic nature, which aligns with delusional disorder.

Step 3: Understand Cedric's Change of Belief

Cedric initially did not believe the delusion but after a year of Elias's consistent delusional thinking, he too started believing the same. This indicates that Cedric's delusion was induced by Elias's delusion.

Step 4: Identify the Disorder

The key detail is that Cedric developed similar delusional beliefs by being influenced by Elias. This indicates a shared psychotic disorder, as Cedric developed symptoms by being in close proximity to someone with persistent delusions.

Key Concepts

Schizophreniform Disorder

Schizophreniform disorder is a mental illness that shares many symptoms with schizophrenia. However, there are some key differences that set it apart. This disorder is characterized by a duration of disturbances that last for at least one month but less than six months. If symptoms persist beyond six months, a diagnosis of schizophrenia might be considered instead. Early detection and treatment can significantly enhance the quality of life for those affected.
Symptoms typically include:

• Delusions
• Hallucinations
• Disorganized speech
• Catatonic behavior

These symptoms can cause significant impairment in daily functioning. Affected individuals might struggle with clarity of thoughts, managing emotions, and maintaining relationships.
To arrive at a diagnosis, healthcare professionals often rely on personal interviews, psychological assessments, and reports from family members. It's vital for those experiencing symptoms to seek help early to prevent further disruptions to their lives.

Schizoaffective Disorder

Schizoaffective disorder is another complex mental health condition that combines symptoms of schizophrenia and mood disorders such as depression or bipolar disorder. Understanding this disorder requires recognizing its dual nature: it affects both mood and thought processes.
Key symptoms of schizoaffective disorder include:

• Delusions or hallucinations for at least two weeks, even during a period without mood symptoms
• Mood disorder symptoms, like depression or mania, that occur alongside schizophrenia symptoms

This disorder can significantly disrupt normal activities, with symptoms impacting both thought and mood. Treatment often includes a combination of medications—such as mood stabilizers, antipsychotics, and antidepressants—and psychotherapy, which together can help manage symptoms more effectively.
Those with schizoaffective disorder often face difficulties managing emotions and maintaining relationships. Support from mental health professionals and adherence to treatment plans play a critical role in managing the disorder.

Delusional Disorder

Delusional disorder is marked by the presence of delusions—fixed false beliefs that are unshakeable despite contrary evidence. Unlike schizophrenia, individuals with delusional disorder often don't experience other major psychotic symptoms like hallucinations or disorganized speech. Their functioning in life may remain relatively normal apart from the delusion.
Common types of delusions include:

• Persecutory: Believing that one is being harmed or harassed by another person or group
• Grandiose: Belief of having exceptional abilities, wealth, or fame
• Jealous: Conviction that one's partner is unfaithful without evidence

These delusions can be long-lasting and persistent, often leading to social and occupational difficulties. The treatment of delusional disorder often involves psychotherapy, particularly cognitive behavioral therapy (CBT), which can help patients challenge and change their delusional beliefs.
Antipsychotic medications might be used, although their effectiveness can vary. Building a support system with friends, family, and mental health professionals is crucial for addressing both the delusional components and any associated distress.

Shared Psychotic Disorder

Shared psychotic disorder, also known as folie à deux, is a rare mental disorder where one person develops delusions as a result of a close relationship with another person who has a psychotic disorder and holds strong delusional beliefs. In these situations, the previously unaffected individual begins sharing the same delusions.
This condition often occurs between closely related individuals, like family members or roommates, as seen with Elias and Cedric. The dominant person of the pair, usually the source of the delusion, maintains their beliefs more strongly, while the other person adopts these beliefs due to their close connection.
To diagnose and treat shared psychotic disorder, it’s crucial to:

• Disengage the involved individuals to break the cycle of reinforcing delusions
• Implement individual therapy to address specific delusional thoughts
• Possibly use antipsychotic medication to manage symptoms

The separation often leads to a significant improvement in the delusion-following individual, highlighting the importance of addressing the interpersonal dynamics within the shared relationship as part of the treatment process.