Ahmed Kotbabout 5 years ago
63 year old male claimed that certain person want to harm his son, keep grudges for him, spread rumors about him . With no evidence for all of that, he is diabetic, smoker with family history of psychosis... By the way the patient had hard times this period of time as: got retired, family problems, financial problems So what is the diagnosis and management??
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Selective Mutism
Children with selective mutism do not speak in some social situations where they are expected to speak, such as school, even though they speak in other situations. They will speak in their home around immediate family members, but often will not speak even in front of others, such as close friends or grandparents.
The lack of speech may interfere with social communication, although children with this disorder sometimes use non-spoken or nonverbal means (e.g., grunting, pointing, writing). The lack of speech can also have significant consequences in school, leading to academic problems and social isolation. Many children with selective mutism also experience excessive shyness, fear of social embarrassment and high social anxiety. However, they typically have normal language skills.
Selective mutism usually begins before age 5, but it may not be formally identified until the child enters school. Many children will outgrow selective mutism. For children who also have social anxiety disorder, selective mutism may disappear, but symptoms of social anxiety disorder may remain.
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