Q. A psychiatry intern is examining a 26 year old patient. He finds that the patient hears some voices which are not heard by others. The patient believes that a car follows him daily. On examination the intern finds that the patient is disoriented and not able to recall the date and place of his marriage and other relevant questions from past. The resident does not consider the diagnosis of schizophrenia and orders toxicology screen of the patient. What points of history and examination did not favor the diagnosis of schizophrenia in this patient? 

a. Audible thoughts

b. Thought Repetition

c. Disorientation and memory impairment

d. Delusion of persecution

e. Young age  

The answer is . (c) Disorientation and memory impairment are not a features of schizophrenia. Always rule out organic brain disorders and substance abuse in patients showing such symptoms. Schizophrenia is characterized by psychosis (loss of touch with reality), disturbance of behavior, thought, appearance, speech, abnormal affect, social withdrawal etc. These patients have intact orientation and memory.