Mr Simpson exhibits paranoid delusions and auditory hallucinations.

His condition

has plagued him for about two decades, since he was attending law school and

began to grow suspicious of his classmates in that they were making fun of him. His

delusions progressed to the point that he was asked to leave school and shortly

thereafter, suspicions of coworkers caused him to get fired from his job and cause

him to make extreme sacrifice and behavior alterations to avoid persecution from

others (the case of driving 30 miles for shoes). His appearance and ability to

function is not seriously impaired, but his social functioning is severely limited by

his delusions to the point that he has totally isolated himself from everyone but his

uncle and contacts with mental health workers. These auditory hallucinations

seemingly involve many different voices, leading clearly to a diagnosis of

schizophrenia. There does not appear to be any mood disturbances that would

signify a manic episode or a depressive episode, both of which could involve brief

psychotic episodes. The duration and lack of long term mood disturbances lead me

away from a diagnosis of schizoaffective or schizopreniform disorder. His affect in

the clinical interview was reported as only mildly blunted at most. This leads me

away from a diagnosis of catatonic or disorganized schizophrenia. I feel that given

the frequency of and the preoccupation with the hallucinations and the number of

delusions he suffers from, a diagnosis of Shizophrenia - Paranoid Type, continuous is

warranted. To further classify his disorder, I would like more information about his

feelings toward his delusions. Specifically if he understands they are irrational and

baseless. There is no mention of any general medical condition and although many

of the symptoms of paranoid personality disorder are met, the symptoms occur

exclusively during the course of schizophrenia. The GAF score reflects the current
condition at the time of interview. Mr. Simpson is functional and coherent, but his

delusions are seriously limiting socially and in his ability to keep a job.

Axis I: Schizophrenia - Paranoid Type, continuous

Axis II: None

Axis III: None Reported

Axis IV: occupational problems, social problems, academic problems (past)

Axis V: 50

Ms. Fielding shows signs of paranoid delusions and hallucinations in regards to her

upstairs neighbors accessing her thoughts and repeating them to her. She feels

unable to control or deny these intrusions and attributes it to unsupported claims of

telepathy inherent to all people. Her overt behaviors appear normal as reported by

the crisis team that admitted her to the hospital. I would like more information on

whether or not the voices are constant or whether they coincide with a particular

event that triggers their occurrence.