INSTRUCTIONS FOR THE DOCTOR
Please read the scenario below. Ann Newton has made an appointment with you to discuss her son’s recent hospital admission. Please respond to Ann’s questions as you would in clinical practice.
Last week you were on call and admitted Tom Newton to the local mental health unit. Tom is 19, lives with his parents and is in second year, studying engineering at university.
Tom’s parents called you as his behaviour was markedly disturbed; they suspect Tom has been using illicit drugs. For the last week the television had been telling Tom that it was his role to save the world from itself. When Tom said that the TV had told him that he had to die to save the world, his parents sought help.
The hospital has told Tom’s parents that he has had an acute psychosis. Tom’s mother, Ann, has made this appointment to talk with you about psychosis; she has heard from a friend that Tom is at risk of schizophrenia.
INSTRUCTIONS FOR TOM’S MOTHER, ANN NEWTON
You are nearly 60 years old and about to retire from your position as a school secretary. When you retire you are planning to travel around Australia.
Your eldest daughter is married and lives nearby. Tom, your son, is 19 and still at home. He is in his second year of an engineering degree. Some of Tom’s university friends seem weird to you and you suspect Tom has been trying illicit drugs.
Over the past few weeks Tom’s behaviour had become increasingly worrying—he was saying that the television wanted him to save the world. When Tom announced that the TV had told him that he had to die to save the world, you and your husband decided to take Tom to the local GP.
Tom was admitted to the mental health unit at the hospital. The psychiatrist has said that Tom has had an acute psychosis. A friend told you that acute psychosis can lead to schizophrenia. You have made this appointment with the GP to find out more about this illness. You would like to know the answers to the following questions:
What is an acute psychosis?
What is schizophrenia?
Can it be cured?
What causes it?
Was it my fault?
What will happen to Tom now?
Will I still be able to travel around Australia as planned?
SUGGESTED APPROACH TO THE CASE
Enquire about Tom’s mother’s ideas, concerns and expectations regarding acute psychosis and schizophrenia
No clear diagnosis yet—one psychotic episode is not diagnostic of schizophrenia, but acknowledge that Tom is at risk of schizophrenia
Explain that you can only talk in general terms, not specifically about Tom, because ...