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Psychiatry General c4ffa47f

A 44 year old man presents with fears that his mathematical abilities have been slowly sucked out of his brain for the last four years. He believes an "alien force disguised as a human being" is responsible. To avoid contact with this being, he has isolated himself in a room in a boarding house. He has left his wife and children. After ten years teaching math at a local high, he resigned about 3 years ago. He suppos himself by 'collecting cans." His effect is blunted. His appearance is disheveled,unshaven and unwashed.Which of the following is least suggestive of a schizophrenic disorder in this man?

A
Delusional system
B
Four-year history of symptoms
C
Age of onset
D
Decrease in level of functioning
High-Yield Explanation
Schizophrenia usually develops in young adulthood.The mean age of the first psychotic break is in the early twenties for men. Of men with schizophrenia, 9 of 10 have developed the disorder by age 30.Women tend to develop the disorder at an older age. Developing the disorder at age 40 is unusual. Ref: Nurnberger, Jr. J.I. (2008). Chapter 3. Psychiatric Genetics. In M.H. Ebe, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds), CURRENT Diagnosis & Treatment: Psychiatry, 2e.

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