A 36-Year-Old Woman Is Brought to the Outpatient Psychiatry Clinic

A 36-year-old woman is brought to the outpatient psychiatry clinic by her husband.  He says that his wife was fine and working as a store clerk until about 8 months ago, when they relocated to another state for his new job.  Soon after, the patient's behavior abruptly changed.  She became suspicious of her neighbors and has remained convinced that they are secretly monitoring her with hidden cameras planted outside the couple's new apartment.  She claims that she hears the neighbors whispering about her every night, and her husband has seen her shout at other people when no one is in the room.  The patient has stopped cleaning and cooking and is fearful of going outside.  For the past month, she has refused to pick up their daughter at school as she believes the child has been replaced by an imposter.  She hears voices warning her that "this is not your child."  The patient has no history of similar signs or symptoms, and there is no family history of psychiatric illness.  Physical examination is unremarkable.  Recent results of blood work, urine toxicology, and a brain CT scan were also normal.  The husband asks if his wife will be okay.  Which of the following is the most appropriate statement regarding this patient's prognosis?

A) Patients presenting at her age generally do not fare as well as younger patients.
B) Patients with a more gradual onset of symptoms tend to have a better outcome.
C) Unfortunately, patients with delusions and hallucinations tend to have a poor outcome.
D) Your wife should return to her normal self after adjusting to these life changes.
E) Your wife's presentation suggests a relatively favorable prognosis.