Signs and Symptoms
Robert shows lack of interest in personal care, likes spending time alone and does not like company. Moreover, he shows no respect for others and recently, he claims to perceive things others cannot hear or see. He also believes he is being tracked via a micro-chip implanted in his body, which makes him behave badly.
DSM-IV-TR Diagnosis
Robert’s symptoms are characteristic of mood disorder features. Based on the DSM criteria, Robert’s condition can be diagnosed as “Bipolar I Disorder, Most Recent Episode Mixed, and Severe with Psychotic Features” (APA, 2000, p. 336). He manifests some features of psychosis, which are also present in depressive episodes and schizophrenia. These symptoms include seeing or hearing images others cannot perceive (hallucinations), and believing in false ideas about oneself (delusions).
Explanation
Robert displays symptoms that are common during psychosis (manic phase), depression and schizophrenic disorders. Delusion of reference is apparent in his claim that someone sends him messages via a micro-chip instructing him to do bad things. His firm, albeit, false beliefs are signs of a bipolar disorder and schizophrenia hence, his diagnosis is ‘mixed bipolar I disorder’. His hallucinations, though common in schizophrenics, also occur in people with depressive psychosis (APA, 2000). His lack of interest in personal care and anti-social attitude are characteristic of bipolar disorder (BPD) and psychosis, whereby an individual loses interest in social relationships due to paranoia.
Conclusion
In the case provided, Robert displays bipolar disorder with psychotic symptoms and depression. Psychotic features (delusions and hallucinations) mark the bipolar I disorder, but can also appear in depressed individuals and schizophrenics. Robert experienced hallucinations and was delusional as he claimed to perceive things others could not perceive.
Reference
American Psychiatric Association [APA]. (2000). Diagnostic and statistical manual of mental disorders, (DSM-IV). Washington, DC: APA.