A person aged 36 years is having firm belief that his wife is having affair. He often sits alone, muttering himself and hears voices commenting about him. He was absolutely normal 2 weeks before. Most likely diagnosis is
**Core Concept**
The person in question is experiencing a sudden onset of psychotic symptoms, including delusions and auditory hallucinations, which are indicative of a psychotic disorder. This condition is characterized by a disconnection from reality, often accompanied by a significant impairment in social and occupational functioning.
**Why the Correct Answer is Right**
The patient's symptoms, such as hearing voices commenting about him and having a firm belief that his wife is having an affair, suggest a diagnosis of Schizophrenia. The presence of auditory hallucinations and delusions, particularly the sudden onset of these symptoms, is a hallmark of this disorder. The brain's neurotransmitter imbalance, particularly the dopamine hypothesis, is thought to contribute to the development of schizophrenia. The patient's sudden onset of symptoms, within a 2-week period, is also consistent with a diagnosis of schizophrenia.
**Why Each Wrong Option is Incorrect**
**Option A:**
This option is incorrect because the patient's symptoms do not suggest a primary mood disorder, such as depression or bipolar disorder. While mood disorders can also present with psychotic symptoms, the sudden onset and nature of the patient's symptoms are more characteristic of schizophrenia.
**Option B:**
This option is incorrect because the patient's symptoms do not suggest a primary anxiety disorder. Anxiety disorders can present with auditory hallucinations, but the presence of delusions and the sudden onset of symptoms are more characteristic of schizophrenia.
**Option C:**
This option is incorrect because the patient's symptoms do not suggest a primary personality disorder. Personality disorders are characterized by long-standing patterns of thought and behavior that are maladaptive and inflexible, and do not typically present with sudden onset of psychotic symptoms.
**Option D:**
This option is incorrect because the patient's symptoms do not suggest a primary substance-induced psychotic disorder. While substance use can cause psychotic symptoms, the sudden onset and nature of the patient's symptoms are more characteristic of schizophrenia.
**Clinical Pearl / High-Yield Fact**
The sudden onset of psychotic symptoms, particularly within a 2-week period, is a red flag for schizophrenia. A thorough psychiatric evaluation, including a detailed history and mental status examination, is essential in diagnosing schizophrenia and distinguishing it from other psychiatric disorders.
**Correct Answer:** C.