At the age of 20, Myles was brought to a hospital emergency 

At the age of 20, Myles was brought to a hospital emergency room by campus security of the college from which he had been suspended several months ago.

At the age of 20 Myles was brought to a hospital emergency

Patient Story: Schizophrenia

At the age of 20, Myles was brought to a hospital emergency room by campus security of the college from which he had been suspended several months ago. A professor had called and reported that Myles had walked into his classroom, accused him of taking his tuition money, and refused to leave.

Although Myles had much academic success as a teenager, his behaviour had become increasingly odd during the past year. He quit seeing his friends and no longer seemed to care about his appearance or social pursuits. Myles began wearing the same clothes each day and seldom bathed. He lived with several family members but rarely spoke to any of them. When he did talk to them, he said he had found clues that his college was just a front for an organised crime operation. He had been suspended from college because of missing many classes. His sister said that she had often seen him mumbling quietly to himself and at times he seemed to be talking to people who were not there. He would emerge from his room and ask his family to be quiet even when they were not making any noise.

One year after the incident at College campus, Myles began talking about organised crime so often, and became so agitated on one occasion that his father and sister brought him to the emergency room.

On exam there, Myles was found to be a poorly groomed young man who seemed inattentive and preoccupied. His family said that they had never known him to use drugs or alcohol, and his drug screening results were negative. He did not want to eat the meal offered by the hospital staff. He also voiced concern that they might be trying to hide drugs in his food.

His father and sister told the staff that Myles’ great-grandmother had a serious illness and had lived for 30 years in a state hospital, which they believed was a mental hospital. Myles’ mother left the family when Myles was very young. She has been out of touch with them, and they thought she might have been treated for mental health problems.

Myles agreed to sign himself into the psychiatric unit for treatment.

His story reflects a common case, in which a high-functioning young adult goes through a major decline in day-to-day skills. Family and friends can often feel this is a loss of the person they knew. As such, family therapy and psychoeducational approaches can be useful to support treatment and good outcomes are possible!
Reflective questions to answer on next page:

Firstly, explain why schizophrenia is defined as a spectrum disorder:

Secondly, from the case study information on the above:
a.    Identify the symptoms and their categories (e.g., delusion: belief that professor had taken tuition money)

b.    Indicate where on the schizophrenia spectrum Myles fits, and why (e.g., Brief Psychotic Disorder, Delusional Disorder… in saying why, also, identify the defining characteristics/symptoms)

Thirdly, why might some people with schizophrenia have difficulties with treatment adherence?

Finally, what could be some approaches to support treatment adherence?