Kevin recently attended his first appointment at the mental health clinic. At 25 years of age, Kevin lives with his cousin Natalie and works for a radio station. Natalie is worried about Kevin because he is spending increasing amounts of time at home, locked in his room, playing loud music. When she asks him to turn it down Kevin just ignores her and buries his head under his pillow.
Natalie encouraged Kevin to talk to someone about his problems and told him that he would have to move out of her house if he didn’t get help soon. Kevin agreed to go see a therapist because he had nowhere else to live.
During the appointment, Kevin revealed some startling things. While working at the radio station, he became convinced that he heard his coworkers talking about him. He believed that his coworkers were calling him a liar and a thief. Kevin determined that they must have found out that he occasionally stole money out of his mother’s purse when he was a young boy. Kevin believed that his coworkers were broadcasting a nighttime radio show that was all about him and all the bad things he had done.
Further, Kevin believed that the show was raising thousands of advertising dollars that were being sent to the Middle East to fund terrorist groups. He felt terrible about this, and was convinced that there would be a terrorist attack soon because of the money the show about him raised.
Although Kevin never actually heard the show on the radio, he was convinced it was being broadcast. He believed that the disc jockeys were watching him and knew to air the show when Kevin couldn’t listen to the radio. Lately, Kevin believed that he could hear the show when the radio wasn’t on. In order to get away from the voices, Kevin blasted his music and sometimes hid his head under the pillow. Unfortunately, the voices were getting louder and louder and Kevin just couldn’t escape them.
Kevin is an excellent example of a patient with schizophrenia, paranoid type. He experiences auditory hallucinations and delusions of reference and guilt. Recall that the average age for the first episode of schizophrenia in males is 25, exactly the age Kevin is now. In order to determine how best to treat Kevin’s illness, a therapist would like to know about any early behaviors that might have predicted this episode and follow him closely for an extended period of time.
Heather Barnett Veague, Ph.D.
Heather Barnett Veague attended the University of California, Los Angeles,
and received her Ph.D. in psychology from Harvard University in 2004. She
is the author of several journal articles investigating information processing
and the self in borderline personality disorder. Currently, she is the Director
of Clinical Research for the Laboratory of Adolescent Sciences at Vassar
College. Dr. Veague lives in Stockbridge, Massachusetts, with her husband
- National Alliance on Mental Illness, "About Mental Illness." Available online. URL: http://www.nami.org/template.cfm?section=By_Illness. Accessed February 22, 2007.
- American Experience, "People and Events: Recovery from Schizophrenia." Available online. URL: http://www.pbs.org/wgbh/amex/nash/ peopleevents/e_recovery.html. Accessed February 22, 2007.
- John F. Nash Jr., "Autobiography." Availalable online. URL: http://nobelprize.org/economics/ laureates/1994/nash-autobio.html. Accessed May 10, 2007.
- Sylvia Nasar, A Beautiful Mind. New York: Simon and Schuster, 1998, 335.
- American Experience,"Transcript." Available online. URL: http://www.pbs.org/wgbh/amex/nash/filmmore/pt.html. Accessed February 22, 2007.
- See note 2.
- Robert L. Spitzer et al., eds., DSM-IV-TR Casebook: A Learning Companion to the Diagnostic and Statistical Manual of Mental Disorders. 4th ed., Text Revision. (Washington, DC: American Psychiatric Publishing, 2004), 189 - 90.
- H. Hafner et al., "The Influence of Age and Sex on the Onset and Early Course of Schizophrenia." British Journal of Psychiatry 162 (1993): 80 - 86.
- E. Fuller Torrey, Surviving Schizophrenia: A Manual for Families, Consumers and Providers, 3rd ed. New York: Harper Perennial, 1995, p. 79.
- G.A. Fava and R. Kellner, "Prodromal Symptoms in Affective Disorders." American Journal of Psychiatry 148 (1991): 828 - 830.
- British Columbia Schizophrenia Society, "Basic Facts about Schizophrenia," Available online. URL: http://www.mentalhealth.com/book/ p40-sc02.html#Head_4. Downloaded on November 13, 2006.
- Quoted in J.N. Butcher, S. Mineka, and J.M. Hooley, Abnormal Psychology. Pearson: Boston, 2004.
- Harrison et al., "Recovery from Psychotic Illness: A 15- and 25-year International Follow-up Study." British Journal of Psychiatry 178 (2001): 506 - 517.
- N.C. Andreasen, "The Role of the Thalamus in Schizophrenia." Canadian Journal of Psychiatry 42 (1997): 27 - 33.
- J. Hooley and S. Candela, "Interpersonal Functioning in Schizophrenia." In Oxford Textbook of Psychopathology, edited by T. Million, P.H. Blaney, and R.D. Davis. New York: Oxford University Press, 1999.
- J.D. Hegarty et al., "One Hundred Years of Schizophrenia: A Meta Analysis of the Outcome Literature." American Journal of Psychiatry 151, no. 10 (1994): 1409 - 1416.
- E.Q. Wu et al., "The Economic Burden of Schizophrenia in the United States in 2002." Journal of Clinical Psychiatry 66, no. 9 (2005): 1122 - 1129.
- C. Wallace, P.E. Mullen, and P. Burgess, "Criminal Offending in Schizophrenia over a 25-year Period Marked by Deinstitutionalization and Increasing Prevalence of Comorbid Substance Use Disorders." American Journal of Psychiatry, 161 (2004): 716 - 727.
- Suicide and Mental Health Association International, "NARSAD Publishes Top 10 Myths About Mental Illness Based on Nationwide Survey." Available online. URL: http://suicideandmentalhealth associationinternational.org/factsmythsment.html. Accessed February 22, 2007.
Provided by ArmMed Media