Station title: Explanation of Schizophrenia to relative
- Construct
- Instructions to candidate
- Instructions to actor
Construct
The candidate demonstrates the ability to establish rapport with
a distressed relative and to explain the aetiology, nature, signs
and symptoms of schizophrenia, its treatment using both
pharmacological and psychosocial methods, in a way that the
relative understands, and balances accurate and realistic
information with instillation of hope.
Instructions to candidate
This lady, Mrs Bennett, is the divorced mother of one of your
patients, Stephen Bennett, who is a 21-year old university student
recovering from a recurrence (second episode) of a schizophrenic
illness. This first presented with an acute onset 3 years ago. He
has made a good recovery from both episodes, on both occasions he
has been treated with oral haloperidol. He stopped medication one
year after the first episode and relapsed 6 months ago. This
coincided with his final examinations. He is still registered for
his degree with examinations pending. He has had several
girlfriends at university although currently does not have a
relationship. Both illnesses were of sudden onset and symptoms
included auditory hallucinations and thought withdrawal. His mother
is very worried. She has asked to discuss him with you at the
outpatient clinic. Her son is willing for you to discuss his case
with his mother. Explain the nature of schizophrenia and the
long-term prospects for her son.
Instructions to actor
You are Mrs Bennett, your son, Stephen, has been diagnosed as
suffering from schizophrenia. He is a 21 year old university
student, studying engineering. He was always somewhat anxious as a
boy, but achieved well at school. He first became ill at the age of
18years, shortly after going away to university. The onset was
sudden and you had had no warning that anything was wrong. He
arrived home unexpectedly from university and appeared to be
extremely frightened. He thought that other students were stealing
his thoughts from out of his head to prevent him studying. He said
that they were shouting at him outside the house, although you
couldn't hear anything. You became very worried when he barricaded
himself in his room. You contacted your GP who arranged for him to
be admitted to hospital. He was in a psychiatric hospital for eight
weeks. On medication he made a good recovery and appeared to be
back to his normal self. He missed two terms at university, but
returned to continue his studies. After one year he decided to stop
the medication. Six months ago the problem recurred with similar
symptoms. You think that this might have been due to the stress of
examinations. He again recovered after an admission to hospital. He
is now taking regular medication again.
You are a divorced woman with 2 younger children still at home.
You are very worried about the future and things you have read
about schizophrenia in the newspapers. You want to know about the
cause of the illness, what the illness is. You were not told
anything after his first breakdown. You will ask whether it is "a
split personality" whether he is dangerous and whether your younger
children will be safe from him.
Summary of questions of interest:
What is schizophrenia?
Is it a split-mind?
What causes it? Is it caused by parents splitting up?
Is it hereditary?
Are the drug treatments safe?
When will he be able to stop taking the treatment?
How do these drugs work? Are there any side-effects?
Is he likely to pose a risk to others, especially his brother and
sister. What is the likelihood of relapse or deterioration?
Will he be able to get a job and work?
Will he still be able to get married and have children?
Opening statement: "I want to know more about my son's
illness".