Question

Hello I am trying to complete my case study on hallucinations. I am hoping you may assist me in refining this information. I need this to be DSM5 criteria and ICD 10. If you have any recent research avilable I would appreciate it. I have attached my document for your review.

Module 4

Sam Coleman was a 25-year old U.S. Army veteran turned community college student who presented to the emergency room (ER) with his girlfriend and sister. On examination, he was a tall, slim, and well-groomed young man with glasses. He spoke softly, with an increased latency of speech. His affect was blunted except when he became anxious while discussing his symptoms.

Mr. Coleman stated that he had come to the ER at his sister’s suggestion. He said he could use a “general checkup” because of several days of “migraines” and “hallucinations of a spiritual nature” that had persisted for 3 months. His headache involved “sharp, shooting” sensations in various bilateral locations in his head and a “ringing” sensation along the midline of his brain that seemed to worsen when he thought about his vices.

                Mr. Coleman described his vices as being “alcohol, cigarettes, disrespecting my parents, girls.” He denied guilt, anxiety, or preoccupation about any of his military duties during his tour in Iraq, but he had joined an evangelical church 4 month earlier in the context of being “riddled with guilt” about “all the things I’ve done.” Three months earlier, he began “hearing voices trying to make me feel guilty” most days. The last auditory hallucination had been the day before. During this past few months, he had noticed that strangers were commenting on his past sins.

Mr. Coleman believed that his migraines and guilt might be due to alcohol withdrawal. He had been drinking three of four cans of beer most days of the week for several years until he “quit” 4 months earlier after joining the church. He still drank “a beer or two” every other week but felt guilty afterward. He denied alcohol withdrawal symptoms such as tremor and sweats. He had smoked cannabis up to twice monthly for years but completely quit when he joined the church. He denied using other explicit drugs except for one uneventful use of cocaine 3 years earlier. He slept well except occasional nights when he would sleep only a few hours to finish an academic assignment.

Otherwise, Mr. Coleman denied depressive, manic, or psychotic symptoms and violent ideation. He denied po

Answer 1

Mr. Coleman has been experiencing auditory hallucinations where he heard strangers commenting on his past sins. The history also says that he attributed his guilt to alcohol withdrawal, which mean that he was feeling guilty, also the fact that he was having auditory hallucination about the theme of guilt further emphasizes that he has delusions of guilt.

According to DSM - V, the following symptoms are required which Mr.Cole has for the diagnosis of schizophrenia

• Delusions
• Hallucinations
• Impairment in one of the major areas of functioning for a significant period of time since the onset of the disturbance: Work, interpersonal relations, or self-care.

According to ICD-10, the following symptoms are required which Mr.Cole has to be for the diagnosis of schizophrenia.

• delusions of control, influence, or passivity, clearly referred to body or limb movements or specific thoughts, actions, or sensations; delusional perception;
• hallucinatory voices giving a running commentary on the patient’s behavior, or discussing the patient among themselves, or other types of hallucinatory voices coming from some part of the body
• a significant and consistent change in the overall quality of some aspects of personal behavior, manifest as loss of interest, aimlessness, idleness, a self-absorbed attitude, and social withdrawal.

So, in conclusion Mr. Cole meets the criteria for schizophrenia, as he hears voices which have themes of guilt and also has beliefs related to guilt. This has also led him to have disturbances in his daily functions, such as drinking alcohol and consuming drugs. According to ICD-10 he can be diagnosed paranoid schizophrenia,and in DSM - 5 the diagnosis will be schizophrenia.