Which patient with schizophrenia would be expected to have the lowest score in global assessment of functioning?
a. 39 years old; paranoid ideation since age 35 years
b. 32 years old; diagnosed as catatonic at age 24 years; stable for 3 years
c. 19 years old; diagnosed with undifferentiated schizophrenia at age 17
d. 40 years old; disorganized schizophrenia since age 18; frequent relapses
ANS: D
Disorganized schizophrenia represents the most regressed and socially impaired of all the schizophrenias. The 40-year-old patient who has had disorganized schizophrenia since 18 years of age could logically be expected to have the lowest global assessment of functioning. In addition, the patient has been ill for a number of years and has had frequent relapses. The 39-year-old patient who has had paranoid ideation since 35 years of age could be expected to have the highest score, because paranoid schizophrenia of short duration may be less impairing than other types. The patient who was diagnosed as catatonic at the age of 24 years has been stable for more than 3 years, suggesting a higher functional ability. The 19-year-old patient who was diagnosed with undifferentiated schizophrenia at 17 years of age has been ill for only 2 years, and disability in undifferentiated schizophrenia remains fairly stable over time.
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