Virtual patients

Complexity of polypharmacological treatment in a case of resistant schizophrenia

"Please come in," Angela's father says, and you walk into Angela's dark house with him. The shutters are closed, there is a bad smell. When you adjust to the dark, you see piles of dirty shoes and clothes everywhere. There are countless shoe boxes in the middle of the room. Angela is sitting on the sofa, with a modest attitude, her head bowed, her gaze fixed downwards. You ask questions about how she feels and her worries. "The neighbours are watching me, they want to hurt me," she whispers. Can you help her?

author: Dott. Giovanna Todarello, MD, Psychiatry Unit, Dipartimento Salute Mentale ASL Bari (Italy), publicated: 18.02.2022

A sixteen-year-old Colombian lost in Spain

"Stop talking in my head!" 16-year-old Viktor shouts. In the middle of the night, he stands alone in the kitchen, fencing into space with the knife he holds in his hand. He had behaved very strangely mainly in the last three weeks, but the problems started approximatelly half a year before. His parents were very worried about him. This does not look like normal manifestations of puberty and adolescence. Will you handle Viktor's case?

author: Dr. Isabel Hernández Otero, Director of the Department of Child and Adolescent Psychiatry University Hospital Virgen de la Victoria Málaga (Spain), publicated: 10.03.2022

A nineteen-year-old young man who has lost his zest for life

Richard grows up as a healthy boy. All turns around at sixteen years of his age, though. He stops interacting with his peers, withdrawing into himself. When he comes to your office three years later, his difficulties are great. "They urge me to go home and stab my father," he says, referring to the beings he feels inside his body. Richard needs your helping hand.

author: Doc. MUDr. Dana Končelíková, Ph.D. Psychiatric Clinic, University Hospital in Olomouc, publicated: 11.11.2021

19-year-old student hearing voices in her head

"I hear a strange buzzing in my head, sometimes snippets of speech," admits 19-year-old student Rebecca in your office. "Sometimes he talks to me from the corner of the room, but I can't see him," she says. She is shy, withdrawn. But suddenly a change occurs. She starts laughing out loud. Her parents are desperate and extremely worried about their daughter. Can you help bring their daughter back to normal?

author: Assistant Prof. Petelin Dmitriy, Sechenov University, Moscow, Russian Federation, publicated: 22.12.2021

A 16-year-old reincarnated Hitler

"I feel a mental connection with Adolf Hitler. I can communicate with him. Sometimes, I feel like his reincarnation," says 16-year-old George. He has just moved to your city and has come to your clinic accompanied by his mother.
"Since childhood, he has been especially timid and shy with his peers, and these aspects worsened with the transition to high school," his mother admits. Can you help George?

author: Dr E. Cognolato, Dr L. Siri, Prof. L. Nobili, Child Neuropsychiatry Unit - IRCCS Giannina Gaslini, publicated: 02.12.2021

Metabolic and cardiovascular comorbidities in a 61-year-old female patient with chronic schizophrenia

Jane Preston was hospitalised in the Department of Psychiatry via the Centre for Crisis Intervention. She has been treated for paranoid schizophrenia for about 25 years. She was hospitalised due to a relapse of this disorder. She was 61 at the time of the current hospitalisation.

author: Assoc. Prof. Libor Ustohal, MD, Ph.D., Dept. of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, publicated: 25.10.2021

Delusions and insomnia in a 19-year-old male patient

"The intention that man should be happy is not in the plan of Creation." - S. Freud

David is 19 years old. He weighs 90 kg and his height is 175 cm. Thus, his BMI is 29.39, which indicates obesity. There is no data on severe somatic or hereditary diseases in David’s history. His relatives noticed that he began to avoid contact with friends and started to wash frequently.

author: Assoc. Prof. Georgi Panov, MD, PhD Psychiatric Clinic, University Hospital “Prof d-r Stoian Kircovich” Stara Zagora town, Bulgaria, publicated: 17.08.2021

21-year-old male with severe paranoid delusions

Our patient’s name is Petr Drobil. Petr’s clinical picture shows florid psychotic symptoms lasting for about 2 weeks, severe paranoid delusions (“they are coming after me, I don't know exactly who, I have to defend myself, they can hear us”), disorganized thinking up to the level of incoherence, pseudo-philosophizing (Petr is concerned with “coincidence”, why particular things happen concurrently: e.g., when he is outdoors, he wonders why a dog barks and wind blows at the same time). His clinical picture is complemented by auditory hallucinatory experiences at the level of commenting voices, occasionally of an imperative nature (urging him to behave aggressively towards his surroundings or to act suicidally).

author: MUDr. Zuzana Vančová, PhD., 1st Department of Psychiatry, Faculty of Medicine, P. J. Šafárik University, publicated: 28.07.2021

21 years old male, suicide attempt

This scenario is about 21 year old Martin Vlach, who was transferred to the outpatient unit due to clinical psychopathology susceptible to psychosis from the daycare hospital, where he had been hospitalized after a suicide attempt.
In this scenario, your role will change in each part. The possible choices you can make will vary based on the position you'll be given.

author: Clemente Garcia-Rizo, M.D., Ph.D, Schizophrenia Unit - Hospital Clinic - Barcelona, publicated: 29.07.2021

Male, 20 years old – lurasidone

This case report presents the case of a 20-year-old man named Jan Radl being treated for a serious psychiatric disorder. This is a so-called virtual patient, which means that in certain places you will have the possibility to make decisions on how to proceed and face the consequences of your decisions.
Based on your decisions, you will earn a score and your task is to get the maximum score. Good luck!

author: Elis Bartečků, Jana Hořínková, Department of Psychiatry, University Hospital Brno, publicated: 23.02.2021