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Gina P
Gina P, LCSW
Category: Mental Health
Satisfied Customers: 175
Experience:  MSW, LCSW, PIP
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I write fiction and I would like to be as accurate as

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Hi, I write fiction and I would like to be as accurate as possible with regards ***** ***** health issues. I have been conduction interviews but can't quite seen to find and answer to my question. I'm currently writing a storyline and to make it work, a character has to experience fixed delusions, visual and auditory hallucinations simultaneously. He is otherwise functional (although he is a shut in) but believes he is in the company of two other characters that actually do not exist. Delusional disorder seems to allow for a person to function yet maintain a persistent and consistent delusion, allows for olfactory and tactile hallucinations but precludes visual and auditory. Is there any disorder, however rare, that might allow for this kind of scenario? Any help would be greatly appreciated.
Submitted: 7 years ago.
Category: Mental Health
Expert:  Gina P replied 7 years ago.

Hi, Interesting profession!

Psychosis, NOS can have these symptoms, which accounts for the NOS (not otherwise specified). Some of these patients can also remain oriented to place, date, situation, but believe they are someone else and have auditory and visual hallucinations.

You might also consider someone who is under the influence of substances such as amphetamines, hallucinogens, or withdrawal from alcohol. Although, these would not be long term and would dissipate after the drug is out of the system.

Sometimes patients can have a multitude of symptoms that don't necessarily fit into any category, but they are still problematic.

Even diagnosis as common as Bipolar Disorder and Depression can have psychosis associated as symptoms, though less common.

I hope this helps. Please let me know if you have other questions. Gina

Customer: replied 7 years ago.
Hi Gina,
Thank you so very much for your answer. I read a little after receiving it and I have a couple of follow up questions. First, I get the impression that Psychosis NOS is usually a temporary tag until a person can be further diagnosed. I also assume that there are some cases that defy classification and they probably continue to be diagnosed as Psychosis NOS. Is that true?
Second, the scenario I'm working with is similar to the relationship between John Nash and his (imaginary) friend as depicted in the film version of A Beautiful Mind. I understand that in reality, Nash had delusions and auditory hallucinations and that the movie took a lot of liberties. I've read several comments from mental health professionals that these were not credible. I just want to make certain I'm not too outside the realm of credibility so I wonder if you know of any cases similar to this or is it best to classify this as NOS because it's a different kind of animal. Hope this question makes sense; I can rephrase (and shorten!) if you like. Tony
Expert:  Gina P replied 7 years ago.

Hi Tony,

Psychotic Disorder NOS can be a temporary diagnosis, but many times the symptoms just don't fit into other serious mental illness categories, and will be tagged with the NOS specifier. In reality, true SMI patients have a multitude of symptoms that are not textbook. They are very diverse and personal, dependent upon many factors, including past and current history, values, beliefs, etc.

I love reading this type of story and of course, always critique the mentally ill characters as well. However, as long as it is not too far fetched, it is believable, and many lay people really aren't aware of how the true symptoms should be portrayed. A beautiful Mind, although may have taken some liberties, according to text book, but could be believable, and was, based on its popularity.

I do work in an inpatient hospital for the seriously mentally ill, and it is not uncommon to see patients with fixed delusions and auditory, visual, olfactory, and tactile hallucinations. Most of these patients clear with appropriate medications, but not all. And many admit and discharge with the diagnosis of Psychotic DO, NOS. So....I do think this is a believable diagnosis given the symptoms your character exhibits.

Hope this helps. Gina

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