This page is dedicated to organizing various examples of standardized exam questions whose answer is schizoaffective disorder. While this may seem a odd practice, it is useful to see multiple examples of how schizoaffective disorder will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A 29 year old man comes to the clinic because of a 7 week history of increasingly severe insomnia, and daytime fatigue. He has also been recently noticing feelings of guilt, emptiness, a lack of hope, and very “debilitating sadness”. He has withdrawn from any social activity with his friends. He says that for the past 5 years he has heard the voice of a character from a fantasy novel telling him to renounce his family, and avoid any sexual contact with women. He explains that he has had two episodes of depressed mood during the past 3 years. He began taking sertraline therapy during the second episode, and that had helped with his mood, but he stopped the medication besaue he was feeling well (other then persistent hallucinations). He has no past history of any serious illness, and is not currently taking any medications. His physical exam is unremarkable. Mental status exam reveals a depressed mood and restricted affect. HIs thought processes are slightly tangential. He does not appear to be influenced by any internal stimuli. He denies any homicidal or suicidal ideation. What is the most likely diagnosis that explains this patient’s above presentation?
Question # 2
6 weeks after being discharged from the hospital for a psychotic episode, a 39 year old man comes to the clinic for follow up. During the hospitalization he claimed that he was instructed by God to create a new religion, and that a famous gospel singer was deeply in love with him. Today he explains that he still hears the voice of God when he is alone in his apartment but he no longer believes that he should create a new religion (because God has stopped telling him to do this). He says “The Lord in heaven tells me that peace is upon the land, so I myself feel at peace.” His current medications include risperiodne and lorazepam. He will have one to two beers on weekends, and he has used marijuana in the past, but has abstained from it for the past 5 years. He is clean and casually dressed. His vitals are all within normal limits. His physical exam shows no abnormalities. His mental status examination shows a clam affect. Based on this information what is the most likely diagnosis for this patient?
Page Updated: 09.17.2016