Reviewer: Zhao Jingping (Central South University Second Xiangya Hospital)
Xiao Ming (pseudonym) is a student who has just entered high school. His grades in junior high school were above average, but after high school he often loses concentration and his grades drop.
He does not have a good relationship with other classmates, and always feels that others look down on him. Because of some trivial matters, Xiao Ming got angry a few times, and his classmates gradually stopped playing with him.
Lonely Xiao Ming feels isolated and targeted, thinking that someone is pointing at him behind his back, calling him a “freak”.
Due to the drop in grades, his parents scolded Xiao Ming badly, which made him feel very distressed. He sought help from the school’s psychology teacher, and went to the hospital for treatment at the teacher’s suggestion.
Image source: Zhanku Hailuo
I. Diagnosis and treatment process
During the consultation process, the psychiatrist found that Xiao Ming’s belief that he was “targeted” and “pointed at” lacked factual basis, and he himself could not produce reasonable evidence.
The doctor asked Xiao Ming carefully and found that he was emotionally anxious, irritable, depressed, inattentive, unresponsive, etc., as well as some short-term strange experiences, such as sometimes feeling that others were behind his back Pointing at yourself, being suspicious, etc.
Doctors assessed him through a series of specialized screening and identification tools, and based on the results, he was likely to be in the prodromal stage of mental illness.
At present, further research is needed on the identification and diagnosis of the prodromal stage of schizophrenia, and there are currently no specific diagnostic criteria. It is generally accepted that this stage is called psychotic risk. Syndrome, this is a transitional or status diagnosis for research purposes, not a clinical diagnosis.
Image source: Zhanku Hailuo
Second, coping suggestions
The doctor’s suggestion to Xiaoming is to visit the hospital regularly for follow-up and active monitoring, which can early detect and treat the disease, and shorten the untreated time; accept psychological intervention (such as cognitive behavioral therapy), Effects were assessed by a psychologist.
If symptoms persist or worsen despite regular psychotherapy, some degree of symptom stabilization can be achieved with low-dose medication [1].
It can be seen from the above case that in the prodromal stage of the disease, the symptoms of the patient are not particularly obvious. At this time, the family members often do not realize that the patient is morbid, and blame this situation on the “normal” The pressure is too great and the mind is burdened.”
If the family members realize that the above-mentioned symptoms may be abnormal, take the patient to a professional medical institution for diagnosis and treatment in time, and take systematic and effective treatment at an early stage, which will not only shorten the treatment time and cost less, but also reduce the cost of treatment. The effect is good, it is not easy to relapse, and it can help patients get rid of “inner demons” as soon as possible.
Image source: Zhanku Hailuo
Co-author: Long Yujun, psychiatrist, Second Xiangya Hospital, Central South University
*The content of this article is for the popularization of health knowledge and cannot be used as a specific diagnosis and treatment suggestion, nor can it replace the face-to-face consultation of a licensed physician, and is for reference only.
*The copyright of this article belongs to Tencent Medical Dictionary. Unauthorized reprinting by media is prohibited. Illegal reprinting will be investigated for legal responsibility according to law. Individuals are welcome to forward to the circle of friends.