On admission, the patient exhibited persistent non-bizarre
delusions and ideas of reference with no affective symptoms or sleep
changes. She denied auditory or visual hallucinations. She denied
symptoms of acute mania, such as decreased need for sleep, elevated
mood, and grandiosity. The patient did demonstrate increased
irritability, but this only surrounded confrontation of her delusions.
Labs demonstrated that her lithium level was therapeutic. Collateral
from her outpatient psychiatrist who had followed the patient for
several months in between the two hospitalizations suggested he had
never observed any manic or hypomanic symptoms and the delusions
were the only symptom that had been observed on longitudinal
evaluation. Based on these observations and review of longitudinal
disease course, the patient was diagnosed with delusional disorder,
persecutory type.
On admission, the patient exhibited persistent non-bizarredelusions and ideas of reference with no affective symptoms or sleepchanges. She denied auditory or visual hallucinations. She deniedsymptoms of acute mania, such as decreased need for sleep, elevatedmood, and grandiosity. The patient did demonstrate increasedirritability, but this only surrounded confrontation of her delusions.Labs demonstrated that her lithium level was therapeutic. Collateralfrom her outpatient psychiatrist who had followed the patient forseveral months in between the two hospitalizations suggested he hadnever observed any manic or hypomanic symptoms and the delusionswere the only symptom that had been observed on longitudinalevaluation. Based on these observations and review of longitudinaldisease course, the patient was diagnosed with delusional disorder,persecutory type.
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