Psychotic disorders and schizophrenia are some of the most complicated and challenging diagnoses in the DSM. The symptoms of psychotic disorders may appear quite vivid in some patients; with others, symptoms may be barely observable. Additionally, symptoms may overlap among disorders. For example, specific symptoms, such as neurocognitive impairments, social problems, and illusions may exist in patients with schizophrenia but are also contributing symptoms for other psychotic disorders.
For this Assignment, you will analyze a case study related to schizophrenia, another psychotic disorder, or a medication-induced movement disorder.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing psychotic disorders. Consider whether experiences of psychosis-related symptoms are always indicative of a diagnosis of schizophrenia. Think about alternative diagnoses for psychosis-related symptoms.
Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Identify at least three possible differential diagnoses for the patient.
By Day 7 of Week 7
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
submission information
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK7Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NRNP_6635_Week7_Assignment_Rubric
This PMHNP assignment gives you a case study and asks you to reason toward a diagnosis of a psychotic disorder (or a medication-induced movement disorder) using DSM-5-TR criteria, and to justify your clinical decisions. The goal is to show structured diagnostic reasoning — not just to name a disorder. Here is a framework you can apply to whichever case you are assigned.
Key takeaways
- Anchor every diagnostic claim in specific DSM-5-TR criteria and the case’s own evidence.
- Separate positive symptoms (delusions, hallucinations, disorganization) from negative symptoms (flat affect, avolition).
- Build a differential: schizophrenia vs. schizophreniform, schizoaffective, brief psychotic, delusional, and substance/medication-induced presentations.
- Know the medication-induced movement disorders — acute dystonia, akathisia, parkinsonism, tardive dyskinesia, and NMS — and how they are assessed (e.g., AIMS).
- State your assessment tools, differential reasoning, and a safety/plan of care, all supported by current scholarly sources.
Start with a focused mental status exam
Work through the case and pull out the mental status findings: appearance and behavior, speech, mood and affect, thought process (e.g., tangential, disorganized) and thought content (delusions), perception (hallucinations), cognition, insight and judgment. These observations are the evidence you will map onto criteria.
Apply DSM-5-TR criteria deliberately
For schizophrenia, the core is two or more of the Criterion A symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms) for a significant portion of one month, with continuous signs for at least six months and functional decline. Duration and timing are what separate the differentials, so track them carefully in your case.
Build and narrow the differential
- Schizophreniform: same symptom picture but 1–6 months’ duration.
- Brief psychotic disorder: less than one month, often with a stressor.
- Schizoaffective: mood episodes concurrent with psychosis, plus psychosis without mood symptoms at some point.
- Delusional disorder: delusions without the fuller Criterion A picture.
- Substance/medication-induced or due to another medical condition: rule these out with history, timeline, and labs.
Explain why you keep one diagnosis and reject the others — that reasoning is what earns the marks.
Don’t forget medication-induced movement disorders
If the case points there, know the antipsychotic-related syndromes: acute dystonia, akathisia, drug-induced parkinsonism, tardive dyskinesia, and the emergency of neuroleptic malignant syndrome. Mention standardized monitoring such as the Abnormal Involuntary Movement Scale (AIMS) and what you would adjust in the medication plan.
Structure and sources
A clean structure: brief case summary → MSE findings → differential with DSM-5-TR justification → working diagnosis → assessment tools and any labs → plan of care and safety → reflection. Cite the DSM-5-TR and current peer-reviewed sources, and keep protected details professional. Our nursing assignment guide has more on clinical write-ups.