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NSG 3370 Week 7 part 3 (DISCUSSION)

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NSG 3370 Week 7 part 3 (DISCUSSION) A 19-year-old freshman in college has been brought to your office by campus security. The patient had been standing on top of the school chapel proclaiming that he was the prophet of God and that God was speaking to him. In fact, he claimed to actually hear God’s voice. When he is in your office you notice that he is speaking very fast, can’t seem to sit still and his sentences at times don’t seem to make sense. He states, “I saw the professor sit on the ham sandwich and eat the raw calculus in his mind” • What is your differential diagnosis, how does it fit how might it not fit? • Based on the top of your differential what is the epidemiology of that disorder? Differential Dx: Schizophrenia is a chronic mental neurodevelopmental psychiatric disorder that affects an individual’s thought process; emotional well-being, and behaviours. Genetic and environmental factors contribute to this disorder (Ghosh, Chakraborty, & Mattoo, 2011). Symptoms of schizophrenia are categorized into three core features: Positive; negative; and cognitive. Individuals with positive symptoms experience agitation, hallucinations, delusions, thought disorder, and disorganized disorder; they are clearly identified and commonly are lead to hospitalization (Ghosh et al., 2011). Those individuals with negative symptoms are associated with disruptions to normal emotions and behaviors such as: flat affect, loss of feeling to enjoy everyday life, unable to focus on tasks, and limit themselves from speaking (Ghosh et al., 2011). Symptoms of cognitive are subtle, but can be severe such as change in memory, poor functioning, unable to focus or pay attention, and difficulty with memory (Ghosh et al., 2011). In this case study, the freshman is exhibiting positive symptoms of schizophrenia along with displaying disorganized speech bizarre behaviors. Epidemiology of schizophrenia appears to effect 1% of the population and prevalent in both males and females; though a higher onset in males from young adult (Ghosh et al., 2011). Borderline Personality Disorder (BPD) is characterized by a cluster of unstable emotions of impulsiveness, instability, and poor self-image (Bhome & Fridrich, 2015). Individuals with this disorder, exhibit symptoms such as: identity disturbance, avoiding abandonment, unstable personal relationships, impulsive behaviors, suicidal ideation, self-harming (cutting), constant feeling of boredom, uncontrollable anger, and dissociative feeling (out of body experience) (Bhome & Fridrich, 2015). This order could fit for this scenario due to the freshman has identity disturbance, impulsive behaviors, and dissociative feeling. Though he/she does not exhibit other symptoms at this time. Methamphetamine use disorder is a psychostimulant releases and blocks the reuptake of monoamine neurotransmitters, including dopamine, norepinephrine, and serotonin Sulaiman, Said, Habil, & Rashid, 2014). Manifestations seen in individuals with this disorder are: excessive bouts of energy and alertness, euphoria, insomnia, weight loss, mood and cognitive changes such as irritability, anxiety, aggression, and paranoia (Sulaiman et al., 2014). This differential could fit due to the freshman experiencing increased energy such as fast speaking and unable to sit still. Bhome, R. & Fridrich, P. (2015). Borderline personality disorder. British Journal of Hospital Medicine, 76(1), 14-16. doi: 10.12968/hmed.2015.76.1.c14 Ghosh, A., Chakraborty, K., & Mattoo, S. K. (2011). Newer molecules in the treatment of schizophrenia: A clinical update. Indian Journal of Pharmacology,43(2), 105–112. Sulaiman, A. H., Said, M. A., Habil, M. H., & Rashid, R. (2014). The risk and associated factors of methamphetamine psychosis in methamphetamine-dependent patients in Malaysia. Comprehensive Psychiatry Supplement, 55(1), 89-94. doi: 10.1016/jcomppsych.2013.01.00

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NSG 3370 Week 7 part 3 (DISCUSSION)


A 19-year-old freshman in college has been brought to your office by campus security. The
patient had been standing on top of the school chapel proclaiming that he was the prophet of God
and that God was speaking to him. In fact, he claimed to actually hear God’s voice. When he is
in your office you notice that he is speaking very fast, can’t seem to sit still and his sentences at
times don’t seem to make sense. He states, “I saw the professor sit on the ham sandwich and eat
the raw calculus in his mind”
• What is your differential diagnosis, how does it fit how might it not fit?
• Based on the top of your differential what is the epidemiology of that disorder?


Differential Dx:
Schizophrenia is a chronic mental neurodevelopmental psychiatric disorder that affects an
individual’s thought process; emotional well-being, and behaviours. Genetic and environmental
factors contribute to this disorder (Ghosh, Chakraborty, & Mattoo, 2011). Symptoms of
schizophrenia are categorized into three core features: Positive; negative; and cognitive.
Individuals with positive symptoms experience agitation, hallucinations, delusions, thought
disorder, and disorganized disorder; they are clearly identified and commonly are lead to
hospitalization (Ghosh et al., 2011). Those individuals with negative symptoms are associated
with disruptions to normal emotions and behaviors such as: flat affect, loss of feeling to enjoy
everyday life, unable to focus on tasks, and limit themselves from speaking (Ghosh et al., 2011).
Symptoms of cognitive are subtle, but can be severe such as change in memory, poor
functioning, unable to focus or pay attention, and difficulty with memory (Ghosh et al., 2011).
In this case study, the freshman is exhibiting positive symptoms of schizophrenia along with
displaying disorganized speech bizarre behaviors.
Epidemiology of schizophrenia appears to effect 1% of the population and prevalent in both
males and females; though a higher onset in males from young adult (Ghosh et al., 2011).
Borderline Personality Disorder (BPD) is characterized by a cluster of unstable emotions of
impulsiveness, instability, and poor self-image (Bhome & Fridrich, 2015). Individuals with this
disorder, exhibit symptoms such as: identity disturbance, avoiding abandonment, unstable
personal relationships, impulsive behaviors, suicidal ideation, self-harming (cutting), constant
feeling of boredom, uncontrollable anger, and dissociative feeling (out of body experience)
(Bhome & Fridrich, 2015). This order could fit for this scenario due to the freshman has identity
disturbance, impulsive behaviors, and dissociative feeling. Though he/she does not exhibit other
symptoms at this time.

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