A 32-year-old woman is hospitalised with persecutory delusions and command auditory hallucinations for 6 weeks. She simultaneously develops a 2-week episode of elevated mood, grandiosity, and decreased sleep. Both psychotic and mood symptoms resolve fully with treatment. What is the DSM-5 diagnosis?

• A Bipolar I disorder with psychotic features
• B Brief psychotic disorder
• C Schizophreniform disorder
• D Schizoaffective disorder, bipolar type ✓

Explanation

DSM-5 schizoaffective disorder requires: (1) an uninterrupted illness with a major mood episode concurrent with Criterion A of schizophrenia, (2) delusions or hallucinations for ≥2 weeks in the absence of a major mood episode, and (3) mood symptoms present for the majority of the total duration. Here psychosis predates the mood episode and extends beyond it; this pattern fits schizoaffective disorder, bipolar type. Bipolar I with psychotic features requires psychosis only during mood episodes. Schizophreniform applies when total duration is 1–6 months without the mood-dominance pattern.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.