Clinical assessment of a 25-year-old male with psychotic symptoms

Mental Health

Presenting Problem

The patient is a 25-year-old male, single, unemployed, living with parents. The person seeking treatment in this case has been experiencing some extreme problems that have developed somewhat rapidly over the course of six months. The problem is very severe and has interfered with all of his personal relationships. He was recently fired from his janitorial job at a school for scaring the students with his words and actions. The patient has not sought treatment before but is now due to his parent's concern and him becoming much more violent and demonstrating strange and odd behavior. The patient claims to be hearing many voices in his head urging him to do strange acts. The patient has also recently taken up a hobby of collecting dead animals and placing them in mailboxes and other public places.

History of the Problem

The patient has described his life becoming more and more confusing over the last few years. The patient was always a poor student and has been arrested twice for violent behavior as a teenager. The patient's violent spells have come and gone since his early teenage years but he is expressing a strong feeling of loss of control in his current state. The patient claimed that he has heard many different voices in his head since the age of 13.

Prior Treatment History

The patient has never seen a mental health specialist until now. The patient has taken many illegal psychedelic drugs in his teenage years. The patient currently smokes three packs of cigarettes a day and has taken Chantix in a past failed attempt in quitting his smoking habit.

Medical History

The patient has never been hospitalized for medical illness, nor for any other reason outside his tonsillectomy he received at age 9. The patient does not take any prescription drugs.

Family History

The patient lives with his father and his stepmother. The patients real mother committed suicide in a mental institution when he was three years old. His mother's brother, or his uncle also committed suicide by jumping off a bridge. The patient was there with his cousin when this suicide took place. The patient is an only child. Both of the patient's grandmothers were diagnosed with paranoid schizophrenia and were institutionalized late in life.

Developmental History

The patient does not remember his mother. His father's marriage to his stepmother occurred when he was 14 years old. The patient revealed he has had a sexual relationship with his stepmother since he was 16 years old.

Educational History

The patient graduated from high school as an average student. He described his educational experience as boring and limiting to his imagination.

Work History

Shortly after graduating high school the patient took the janitor job that he recently lost.

Legal History

The patient has been arrested twice for violent behavior. Both instances surrounded him being attacked by mysterious forces. The court cases for the patient notes his arrests were for disturbing the peace.

Sexual Relationship History

The patient is bisexual. He claims the abuse he suffered at the hands of his stepmother was part of God's plan.

Treatment

Because the causes of schizophrenia are still unknown, treatments focus on eliminating the symptoms of the disease. Treatments include antipsychotic medications and various psychosocial treatments. Many drugs such as Chlorpromzaine, perphanezaine, olanzapine and aprirpazlole are often prescribed. Psychosocial treatments can help people with schizophrenia who are already stabilized on antipsychotic medication. Psychosocial treatments help these patients deal with the everyday challenges of the illness, such as difficulty with communication, self-care, work, and forming and keeping relationships. Learning and using coping mechanisms to address these problems allow people with schizophrenia to socialize and attend school and work.