19-year-old student hearing voices in her head
Initial examination
Two devastated people sit in front of you: a father and a mother, worried about their daughter. Without asking them a question, they begin describing their problem themselves.
"Rebecca has always been a healthy child. My pregnancy was fine, she has always developed in accordance with the age norms," says Rebecca's mother at the initial examination. The father nods in agreement and continues the story, to relieve his wife of a difficult situation:
"Rebecca quickly learned to talk and count. She spent a lot of time reading books. She was shy by nature, found it hard to make friends, avoided noisy company and parties,” says her father.
According to both parents, she always studied well at school. Two years ago, she successfully started university in the field of cultural studies. She completed the first year without difficulty. But then a change occurred.
During the autumn semester in the second year, her mental health state worsened for no apparent reason.
"She stopped taking care of her appearance, started skipping classes at university, stopped communicating with her few friends, and spent most of her time locked up in her room," says the father.
The mother is upset, her voice is shaking. "During communication with us, from time to time she began to say strange things, with no meaning. We stopped understanding her," whispers the mother.
"Even scarier were situations when she seemed to be talking to someone invisible or listening to something that we couldn't hear," adds the father. As the worst case, he describes situations in which Rebecca falls into unreasonable bursts of laughter.
OK, I got it.
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.