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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}
|QuestionAuthor= {{SSK}} (Reviewed by Serge Korjian)
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Behavioral Science/Psychiatry
|MainCategory=Behavioral Science/Psychiatry
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|MainCategory=Behavioral Science/Psychiatry
|MainCategory=Behavioral Science/Psychiatry
|SubCategory=General Principles
|SubCategory=General Principles
|MainCategory=Behavioral Science/Psychiatry
|MainCategory=Behavioral Science/Psychiatry
|MainCategory=Behavioral Science/Psychiatry
|MainCategory=Behavioral Science/Psychiatry
|MainCategory=Behavioral Science/Psychiatry
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|MainCategory=Behavioral Science/Psychiatry
|MainCategory=Behavioral Science/Psychiatry
|SubCategory=General Principles
|SubCategory=General Principles
|Prompt=A 35 year old woman has lived alone most of her adult life. She has no friends and does not like leaving the house much. She has never had an intimate relationship and prefers being alone. She spends her days drawing and collecting random objects which she fashions into dolls. What is the most likely personality disorder present in this patient?
|Prompt=A 42-year-old man has been living alone for the past 20 years. His neighbors have always noticed that the man has unusual habits, spending most of his time collecting leaves and burning them in his backyard while chanting. He speaks a weird form of English he calls Janglo which he claims is the language he uses to contact magical creatures from a parallel world. He admits he has never seen or heard from these creatures but he believes they exist. The man is not very fond of socializing although he does not mind being around people. What is the most likely disorder present in this man?
|Explanation=Schizoid personality disorder is characterized by voluntary social withdrawal and indifference. Patients with schizoid personality disorder express little emotion and are content with being socially isolated and not having relationships. They usually feel little if any desire for sexual relationships. Patients typically have hobbies and daily work activities that require as little social contact as possible. On the other hand, avoidant personality disorder describes a pattern of hypersensitivity and social inhibition in patients who are usually very shy. These patients desire social relationships but are very timid, often feel inadequate, and are afraid of rejection.
|Explanation=Schizotypal personality disorder is a pervasive pattern of being usually beginning in early adulthood characterized by weird and eccentric appearance, magical beliefs, bizarre fantasies or preoccupations, and odd thinking and speech. Patients can also have some form of social withdrawal, lack of friends, and inappropriate affect. Patients with schizotypal personality disorder do not have visual or auditory hallucinations, and not have social, personal, and intellectual decline seen in patients with schizophrenia.
 
|AnswerA=Schizotypal personality disorder
Five features are usually seen in schizoid personality disorder: Social withdrawal, social detachement, intimacy avoidance, restricted affectivity, and anhedonia.
|AnswerAExp=Schizotypal personality disorder fits this man's description closely. Schizotypal personality disorder is characterized by weird and eccentric appearance, magical beliefs, bizarre fantasies or preoccupations, and odd thinking and speech.
 
|AnswerB=Schizoid personality disorder
Educational objective: Schizoid personality disorder is characterized by voluntary social withdrawal with no desire for social contact or relationships.
|AnswerBExp=Schizoid personality disorder is characterized by voluntary social withdrawal and indifference. The patient neither desires nor enjoys close relationships, and almost always chooses solitary activities. Other features include anhedonia, intimacy avoidance, and restricted affectivity.
 
|AnswerC=Schizophrenia
References: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA:American Psychiatric Publishing.
|AnswerCExp=Schizophrenia is a mental disorder that usually presents with auditory hallucinations, bizzare often paranoid delusions, and disorganized thinking and speech. Patients also experience overall social, personal, emotional and intellectual decline usually showing social withdrawal, bad hygiene, loss of judgment and anhedonia. The diagnosis of schizophrenia is usually made if symptoms are present for more than 1 year.
|AnswerA=Schizotypal
|AnswerD=Schizophreniform disorder
|AnswerAExp=Schizotypal personality disorder is characterized by weird and eccentric appearance, magical beliefs, bizarre fantasies or preoccupations, and odd thinking and speech. Patients can usually have some form of withdrawal but not as prominent as in schizoid personality.
|AnswerDExp=Schizophreniform disorder has the same features as schizophrenia but it is usually lasts between 1 and 6 months. It increases the risk for developing schizophrenia later on.
|AnswerB=Schizoid
|AnswerE=Acute psychotic episode
|AnswerBExp=This patient exhibits the typical features of schizoid personality disorder. The patient neither desires nor enjoys close relationships, and almost always chooses solitary activities. Other features include anhedonia, intimacy avoidance, and restricted affectivity.
|AnswerEExp=Acute psychotic episode is also similar to schizophrenia but lasts less than 1 month.
|AnswerC=Avoidant
|EducationalObjectives=Schizotypal personality disorder is characterized by weird and eccentric appearance, magical beliefs, and bizzare preoccupations. Patients usually do not have visual or auditory hallucinations.
|AnswerCExp=Avoidant personality disorder is characterized by avoidance of activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection. The patient usually desires relationships but is afraid of possible consequences.  
|References=American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA:American Psychiatric Publishing.
|AnswerD=Dependent
|RightAnswer=A
|AnswerDExp=Dependent personality disorder is characterized by a submissive personality often with very low self esteem. Patients usually have a constant need to be taken care of.
|WBRKeyword=Schizotypal personality disorder, Schizophrenia, Cluster A, Personality disorders
|AnswerE=Borderline
|Approved=Yes
|AnswerEExp=Borderline personality disorder is characterized by a pervasive pattern of instability of interpersonal relationships and self-image. Patients are usually impulsive, have a pattern of intense unstable relationships, and recurrent suicidal behavior or threats.
|RightAnswer=C
|WBRKeyword=Schizoid personality disorder, Avoidant personality disorder
|Approved=No
}}
}}

Latest revision as of 00:55, 28 October 2020
Author [[PageAuthor::Serge Korjian M.D. (Reviewed by Serge Korjian)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Behavioral Science/Psychiatry
Sub Category SubCategory::General Principles
Prompt [[Prompt::A 42-year-old man has been living alone for the past 20 years. His neighbors have always noticed that the man has unusual habits, spending most of his time collecting leaves and burning them in his backyard while chanting. He speaks a weird form of English he calls Janglo which he claims is the language he uses to contact magical creatures from a parallel world. He admits he has never seen or heard from these creatures but he believes they exist. The man is not very fond of socializing although he does not mind being around people. What is the most likely disorder present in this man?]]
Answer A AnswerA::Schizotypal personality disorder
Answer A Explanation AnswerAExp::Schizotypal personality disorder fits this man's description closely. Schizotypal personality disorder is characterized by weird and eccentric appearance, magical beliefs, bizarre fantasies or preoccupations, and odd thinking and speech.
Answer B AnswerB::Schizoid personality disorder
Answer B Explanation [[AnswerBExp::Schizoid personality disorder is characterized by voluntary social withdrawal and indifference. The patient neither desires nor enjoys close relationships, and almost always chooses solitary activities. Other features include anhedonia, intimacy avoidance, and restricted affectivity.]]
Answer C AnswerC::Schizophrenia
Answer C Explanation [[AnswerCExp::Schizophrenia is a mental disorder that usually presents with auditory hallucinations, bizzare often paranoid delusions, and disorganized thinking and speech. Patients also experience overall social, personal, emotional and intellectual decline usually showing social withdrawal, bad hygiene, loss of judgment and anhedonia. The diagnosis of schizophrenia is usually made if symptoms are present for more than 1 year.]]
Answer D AnswerD::Schizophreniform disorder
Answer D Explanation AnswerDExp::Schizophreniform disorder has the same features as schizophrenia but it is usually lasts between 1 and 6 months. It increases the risk for developing schizophrenia later on.
Answer E AnswerE::Acute psychotic episode
Answer E Explanation AnswerEExp::Acute psychotic episode is also similar to schizophrenia but lasts less than 1 month.
Right Answer RightAnswer::A
Explanation [[Explanation::Schizotypal personality disorder is a pervasive pattern of being usually beginning in early adulthood characterized by weird and eccentric appearance, magical beliefs, bizarre fantasies or preoccupations, and odd thinking and speech. Patients can also have some form of social withdrawal, lack of friends, and inappropriate affect. Patients with schizotypal personality disorder do not have visual or auditory hallucinations, and not have social, personal, and intellectual decline seen in patients with schizophrenia.

Educational Objective: Schizotypal personality disorder is characterized by weird and eccentric appearance, magical beliefs, and bizzare preoccupations. Patients usually do not have visual or auditory hallucinations.
References: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA:American Psychiatric Publishing.]]

Approved Approved::Yes
Keyword WBRKeyword::Schizotypal personality disorder, WBRKeyword::Schizophrenia, WBRKeyword::Cluster A, WBRKeyword::Personality disorders
Linked Question Linked::
Order in Linked Questions LinkedOrder::
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