Vignette Number GAP 018
Speciality:
General Psychiatry
Date:
10 October 2001
Vignette:
A 19-year-old single man in his first year at university is
referred for emergency admission by a general practitioner. He is
perplexed, frightened and expresses ideas of persecution, but is
willing to be admitted to hospital. He lives in a student flat.
Outline how you would assess and manage him in hospital for the
next 48 hours, and what you would say to his parents who ask you
what is wrong with him; they wonder if it might be
schizophrenia.
Suggested Probes:
- How are you going to clarify the diagnosis?
- Would you prescribe medication?
- Would you see the parents on their own and what would you say
to them?
- History to include academic performance from university and
anyone sharing his flat.
- Discussion of physical assessment and drug screen.
- Discussion of ward management including pros and cons of
withholding antipsychotic medication.
- Issues of consent for discussion with parents.
- The only truthful answer to the parents' question is that it is
too early to tell. The information should be given
sensitively.