Old NBME q- Psych

[student456]

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25. A 22-year-old woman is brought to the emergency department by police after they found her walking naked down the middle of the street. She is screaming that the police are planning to hurt her and that they are members of a secret society that has been following her for months. She is not cooperative with history taking and says quickly, "Plants aren't often watered. Those doorknobs need polishing. Where's the merry-go-round?" She is emaciated, dirty, and disheveled. Laboratory studies show mild microcytic anemia. Urine toxicology screening is negative. Which of the following is the most likely diagnosis?

A. Adjustment disorder with disturbance of conduct
B. Dissociative fugue
C. Schizophreniform disorder
D. Schizotypal personality disorder
E. Substance-induced mood disorder

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I'm stuck between C and D.

It's only the girl who mentions the "months" so for that reason do we go with C? Or since she does have magical thinking and unclear about how many months we go with D? I actually went with D.

 

[Transposony]

Cannot be D since she is having paronia.
Schizotypal personality disorders dress oddly but not dirty and disheveled and there is no malnutrition and they are able to function in the society (just like that weird cousin/uncle/ classmate/ neighbor etc).
Also, personality disorders usually have years of history not months.
She clearly have "pressure of speech" as well as "disorganized speech" which is also in favor of C .

 

[student456]

Thank you .... That helped clear it.