A nineteen-year-old young man who has lost his zest for life
First examination
A nineteen-year-old young man comes to your office. He finished secondary school a few weeks ago. While his peers are full of strength and energy and spend most of their time together, Richard is different at first sight.
You talk together. You ask about his family.
“I have a sister, a twin. And a younger brother,” he enumerates his siblings in a quiet voice. He is laconic.
You consult his medical file. He has a positive family history. After pregnancy with his younger brother his mother suffered postpartum psychosis. His mother´s sister committed suicide for unknown reasons.
"The boy has difficulty expressing himself and attends speech therapy regularly," the paediatrician says in an earlier medical record. Otherwise, he develops as any other healthy child.
"In your medical file, I can see a visit to a paediatric psychiatrist when you were sixteen, what happened then?" you ask the patient. This time he speaks up. He probably realises his problem.
“My dad took me there. He was bothered that I didn't want to play hockey like I used to. And that I didn't want to spend time with my peers. He said I began to change. It's true that I often just stood and stared into space," Richard admits.
He also remembers that he began to have problems with concentration then. The same symptoms are confirmed by records in his medical file.
"The patient states that he has been distracted for about a quarter of a year and cannot remember ordinary things. The activities he used to enjoy are no longer fulfilling for him. He prefers to stay at home and rest," three-year-old records reveal.
Continue to the first diagnosis.
This virtual patient case was created on the basis of clinical practice outside the EU and may, therefore, include an off-label practice.
I agree with playing a virtual patient case authored outside the EU. I will not draw any consequences from this case for my own or any other practice, as this case may contain unapproved use of an approved drug.