The patient: 2000 onset, then junior high school, due to sinusitis repeating a grade and study can not keep up with the disease Main symptoms: at first is suspected that his classmates spy on him, teachers target him, often run out at night, crying, tantrums, now the main symptoms are self-talk, self-smile, autism, ignoring people Consulted at Baoding Sixth Hospital, Shijiazhuang Psychological Hospital, the first hospital of Hebei Medical University, Beijing 261 Hospital, local The first two years before the onset of the disease were very well controlled and no different from normal people, but each time in the middle, the relapse was due to the reduction or discontinuation of medication. In 2009, the first hospital of Hebei Medical University changed to aripiprazole and Zoladin, after half a year of poor results, then changed to olanzapine, stable for two years, but in 11 years in a small local hospital, due to drug reduction and relapse, then changed to Shubili effect is not good, Beijing 261 hospital changed to Quetiapine, stable for two months and relapse, half a month ago changed to olanzapine 30mg, self-talk has not completely disappeared but the mood has greatly improved Yesterday, the self-talk has been bad until now, and the self-talk has become very strong, and he is ignoring people, hiding himself in the house and talking to himself. I don’t know what to do. Should I be hospitalized or can I do it on an outpatient basis? Li Da, Department of Psychological Counseling, Wuxi Mental Health Center
Wuxi Mental Health Center, Department of Psychological Counseling, Li Da.
Does the patient currently have a correct understanding of his illness, does he have denial of illness, refusal to take medication, self-discrimination, etc., and what is his current ability to live and work on his own? Throughout the patient’s medical history and treatment, there is no problem with the diagnosis of schizophrenia, but we need to pay attention to many other problems of the patient other than just medication.
Patient: Thank you for your prompt reply! The patient now knows he has a disease and avoids us every time he talks to himself and does not refuse medication, but he does not admit to talking to himself in front of us and says no when asked by the doctor, so I don’t know why he says that. As for his ability to work, he does not work and does not want to work, and his ability to live is limited to taking care of his own food and clothing, and rarely participates in household chores
Wuxi Mental Health Center, Psychological Consultation Department, Li Da: The patient’s medical history is more than 10 years old and his social function is obviously impaired, so he should receive rehabilitation treatment as soon as possible and not just limit himself to a certain positive psychotic symptom.
Patient: What is the rehabilitation treatment you are referring to? Can he receive rehabilitation treatment now that his condition is not under control? What does rehabilitation treatment involve?
Li Da, Department of Psychological Counseling, Wuxi Mental Health Center: Rehabilitation treatment is required from the beginning of the illness. Rehabilitation includes rehabilitation of psychosocial functions and vocational ability. Sometimes medication cannot solve all of the patient’s problems and other methods are needed to promote recovery. In addition to psychiatrists and nurses, patients need the help of psychotherapists, occupational therapists, and social workers. This is a systematic program that requires the collaboration of the family, the rehabilitation worker, and the patient. The ideal outcome is that the patient is able to care for his or her own health, live independently, and be self-supporting. Patient: I would like to ask if you are available for consultation? If not, do we need to be hospitalized to see you in Wuxi? How long do you usually stay? Is it a psychiatric hospital or a psychological hospital?
Li Da, Department of Psychological Counseling, Wuxi Mental Health Center: Our hospital has established the Wuxi Mental Disability Rehabilitation Center following the model of the largest mental rehabilitation institution in Hong Kong (New Life Rehabilitation Association). Our rehabilitation center is similar to the training school model, we call the patients rehabilitation students, the students have their own dormitory, fully open, there are six rooms, four rooms, three rooms, two-person rooms, one room and other different rooms, under the guidance of therapists students need to take care of their own personal hygiene and dormitory hygiene, their own dining room. The trainees are also required to receive various group and individual rehabilitation training, and are assigned to work in different simulated positions according to their abilities. The ultimate goal is to enable the trainees to achieve the goals of self-care, independent living, self-support and even open employment. The trainees at Wuxi Mental Disability Rehabilitation Center come from different regions. Some trainees from Wuxi are subsidized by the government and they receive rehabilitation treatment for free (which is probably rare in the country), while some of them come to the rehabilitation center in the morning and go home at night; others come to the rehabilitation center on Monday and go home on Friday; there are even some who go out to work during the day and go back to the dormitory of the rehabilitation center at night to rest. Our rehabilitation cycle is 2 months each. For more details, you can search “Wuxi Li Da” on Baidu.