Dorothea is a 42-year-old socialite who has never been hospitalized or sought treatment for mental health problems before. A new concert hall is to be formally opened with the last concert of his career by a world-renowned tenor. Dorothea, due to her position on the cultural council, has assumed the responsibility for coordinating that event. However, construction problems, including strikes, have made it uncertain whether finishing details will meet the deadline. The set designer has been volatile, threatening to walk out on the project unless the materials meet his meticulous specifications. Dorothea has had to calm this volatile man while attempting to coax disputing groups to negotiate. She also has increased responsibility at home as her nanny has had to leave to visit a sick relative. In the midst of these difficulties, her best friend was decapitated in a tragic car crash. Dorothea herself is an only child, and she had been close to her best friend since grade school. People have often commented that the two women were like sisters. Immediately following the funeral, Dorothea became increasingly tense and jittery and only able to sleep 2-3 hours a night. Two days later, she sees a woman driving a car just like the one her friend had driven. She is puzzled, and after a few hours, she becomes convinced that her friend is alive, that the accident had been staged, along with the funeral, as part of a plot. She became distrustful of everyone, except her husband, and believes that the plot is directed towards deceiving her. She believes that her phone is tapped and her neighbors are terrorists who are out to sabotage the opening of the concert hall. She believes that her rooms in her house are bugged and refuses to allow packages to be delivered to her home for fear that they contain bombs or a biological agent. She has also begun to hear soft muted voices that she cannot clearly make out. Upon examination by the psychiatrist in the ER, her husband reports that in the past, Dorothea has experienced periods of paranoia and delusional thoughts, but with time and a decrease in stress, the symptoms have dissipated. What would Dorothea's current diagnosis be? What is your rationale?
