Psychosis - a Case Study

Summative Assessment One: Case Study There are several key issues apparent for Belinda, one of which is social isolation. Belinda has withdrawn from her family and no longer spends time with her friends. In becoming socially isolated, Belinda is at risk of disruption to her social development leading to an increased likelihood of failure to achieve in the future (EPPIC, 2001). This is evidenced by the fact that Belinda’s grades have dropped significantly over the past six months. For the purpose of this essay, three differential diagnoses will be offered, however in clinical practice it is preferable to refrain from diagnosing a client early in treatment due to the stigma associated with being ‘labelled’ (EPPIC, 2001). The first differential diagnosis formulated is Schizophrenia. According to the DSM IV criteria for Schizophrenia, (as cited in Elder, Evans & Nizette, 2005), there must be at least two positive symptoms present for a period of at least one month. This is compatible with the auditory hallucinations and persecutory delusional thinking expressed by Belinda (see Appendix A). Negative symptoms, or absence of normal functioning, are also present in the form of blunted affect, avolition and social withdrawal (see Appendix A). Elder et al. state that social and academic dysfunction must be apparent. These dysfunctions are evident with reports of Belinda’s academic decline and withdrawal from usual activities with friends. Elder et al. further suggests that these disturbances should have been present for at least six months and during this time positive symptoms should have been displayed. This is in accord with the expression of symptoms in Belinda’s case. It is worthy of note that the period of depression, suffered by Belinda when she was 13 years old, may in fact have been part of the prodromal phase of the illness process (EPPIC, 2001). The second differential diagnosis to be considered is Schizoaffective Disorder. This is described by Camer,