A 24-year-old man is brought by his family after six months of progressive social withdrawal, auditory hallucinations telling him he is a divine messenger, and the firm belief that neighbours are implanting thoughts into his mind. He maintains that these experiences are completely real. His affect is flat and he avoids eye contact. Which single criterion below is sufficient by itself to meet Criterion A for schizophrenia under DSM-5-TR?

• A Social withdrawal lasting six months
• B Flat affect observed on mental status examination
• C Disorganised grooming and self-care
• D Auditory hallucinations heard as a running commentary on his behaviour ✓

Explanation

DSM-5-TR Criterion A requires at least two of five symptoms; however, delusions, hallucinations, or disorganised speech alone each count if the hallucination is a voice keeping up a running commentary or two or more voices conversing. A running commentary hallucination therefore satisfies Criterion A on its own. Social withdrawal, flat affect, and poor self-care are negative or associated features but do not independently fulfil Criterion A.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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