Question

the nurse is reviewing the chart of a psychotic patient admitted to the mental health unit. the patient is a 20-year-old male with a suspected diagnosis of schizophrenia. the nurse knows that which part of the patients history support the diagnosis of schizophrenia?

the patient has recently been smoking synthetic marijuana and drinking alcohol.
the patient has been able to function at school and work up until the past week.
the patient has been having hallucinations, delusions, and avolition for the past month.
the patient has been depressed, anxious, and suicidal for several weeks before being admitted.

Explanation:

Analyze diagnostic criteria for schizophrenia

According to DSM-5 criteria, a diagnosis of schizophrenia requires the presence of at least two of the following active-phase symptoms for a significant portion of time during a 1-month period: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms (such as avolition). At least one of these must be delusions, hallucinations, or disorganized speech.

Evaluate the given options

• Option 1: Substance use (synthetic marijuana and alcohol) can cause substance-induced psychosis, which must be ruled out before diagnosing schizophrenia.
• Option 2: Schizophrenia typically requires a continuous disturbance for at least 6 months, including at least 1 month of active-phase symptoms, with significant social or occupational dysfunction. Functioning well until just one week ago does not support this timeline.
• Option 3: Having hallucinations (positive symptom), delusions (positive symptom), and avolition (negative symptom) for the past month directly matches the active-phase symptom criteria required for a diagnosis of schizophrenia.
• Option 4: Depression, anxiety, and suicidality are mood and affective symptoms that are more indicative of depressive disorders or schizoaffective disorder, rather than primary diagnostic criteria for schizophrenia.

Select the correct option

Option 3 is the only choice that describes the core positive and negative symptoms of schizophrenia lasting for the required active-phase duration of at least one month.

Answer:

• (A) The patient has recently been smoking synthetic marijuana and drinking alcohol.
• (B) The patient has been able to function at school and work up until the past week.
• (C) The patient has been having hallucinations, delusions, and avolition for the past month. (Correct answer)
• (D) The patient has been depressed, anxious, and suicidal for several weeks before being admitted.