VeriPsych Case Study #1 | VeriPsych Case Study #2
Paul, 20 years old, was brought in for treatment by his family after two to three weeks of behavior that included delusions, intermittently gibberish talking, speaking of being in hell, and threats towards his parents. At 3am on the night before his arrival in the hospital, Paul broke into his parent’s bedroom and stated “they want to kill us” and “I’m going to kill you.” Under police order, Paul was admitted, with a diagnosis of psychosis not otherwise specified, to an inpatient psychiatric facility where he stayed for one month. Paul was placed on a drug regimen of an anti-anxiety medication, an antipsychotic medication, and an antidepressant medication. His diagnosis upon release was schizophrenia, paranoid type and mood disorder not otherwise specified. When released from the hospital, he was continued on a similar drug regimen to control his symptoms and behavior.
In follow-up interviews, Paul revealed that he smoked marijuana daily and had since he was 16 years of age. He was diagnosed with Attention Deficit Disorder (ADD) as a child and contemplated suicide when he was a teenager during prolonged episodes of depression. His experience with additional drug and alcohol use included occasional social drinking and past experimentation with methamphetamines and ecstasy. His mental state began to deteriorate about five months before being brought into the hospital by his parents. His family had gone out of town and when they returned Paul was talking about strange ideas he had developed about religion, politics and government.
In subsequent visits with his psychiatrist, Paul reported having auditory and visual hallucinations and continued to express his strange thoughts about politics, religion and government. Paul began to put on weight and was having trouble sleeping. Eventually with medication his condition stabilized. Paul’s psychiatrist tried various medications to address his symptoms but was uncertain about a definitive diagnosis of schizophrenia, major depressive disorder or some other psychosis not otherwise specified.
Paul’s psychiatrist ordered the VeriPsych test to help assist in the confirmation of a schizophrenia diagnosis so she could treat Paul accordingly. Paul’s VeriPsych score was 94%, indicating a high probability of schizophrenia and thus consistent with the doctor’s schizophrenia diagnosis. With this supportive result, Paul’s psychiatrist felt comfortable discussing long-term treatment for schizophrenia including a forward-looking regimen of appropriate drugs and applying for disability assistance. In this case VeriPsych provided Paul’s psychiatrist additional confidence to rule out drug-induced psychosis and mood-induced psychosis, and focus on treatment for schizophrenia.
VeriPsych Case Study 2
Greg, 19 years old, arrived at his psychiatrist with thoughts of paranoia, delusions and reported a recent lack of sleep. Greg was well groomed and appeared normal with the exception of silent anxious pacing. The psychiatrist’s evaluation included observations of paranoia, aggression and anxious behavior. Greg believed that heavy traffic traveling in one direction in front of his apartment was an indication of a conspiracy directed at him. Greg reported daily use of marijuana, some thoughts of self-injury, auditory and visual hallucinations and delusional thoughts. In a recent episode he told his mother that voices were telling him that there were people trying to kill him. He was taken to the hospital emergency room where he was treated with first and second generation anti-psychotic medications, as well as anti-anxiety medication. Prior to this episode Greg had no personal or family history of psychiatric illness. Greg was admitted to an inpatient psychiatric facility for one week. He was discharged with a diagnosis of Psychotic Disorder Not Otherwise Specified and was prescribed a second generation anti psychotic medication.
In follow-up visits to the psychiatrist Greg reported that his behavior had become erratic beginning about 10 months prior to his initial contact with his treating psychiatrist. Greg was cooperative but was slowly rocking while seated and appeared sedated. In subsequent visits he denied having thoughts of suicide or homicide and was not experiencing auditory or visual hallucinations. Greg reported feeling “in a daze” and having trouble focusing. His psychiatrist began to switch him to a different second generation anti-psychotic medication due to the intolerable sedation of the first medication he was prescribed. His psychiatrist believed there was a possibility of schizophrenia but also suspected Greg’s episode was temporary psychosis brought on by drug use.
After Greg’s second follow-up visit with his psychiatrist, he completed psychological testing, but the results of this testing were inconclusive. At a third follow-up visit with his psychiatrist, Greg indicated that he felt more normal, was sleeping better and enjoying things. His psychiatrist intended to continue his treatment with the antipsychotic therapy. However, given the complex nature of Greg’s symptoms from his initial visit to subsequent follow-ups, his psychiatrist ordered VeriPsych as an aid in confirming the diagnosis of schizophrenia. His psychiatrist didn’t want to unnecessarily expose Greg to the long-term effects and expense of the medication and was questioning the schizophrenia diagnosis given Greg’s recent return to a normal baseline daily function. His psychiatrist also felt that VeriPsych test results not showing a high probability of schizophrenia would support a decision to taper off Greg’s medications while continuing to monitor him.
In this case, the VeriPsych test yielded a VeriPsych score of 64%, corresponding to an indeterminate probability of schizophrenia (as opposed to a high probability of disease). After discussing the results with Greg and his family and based on Greg’s history, presentation, lab, and current level of functioning, the psychiatrist recommended tapering Greg’s medication with a goal of discontinuing it completely. The family agreed, and Greg began a slow taper off of medication over several months.
Once completely off medication, in follow-up visits with his psychiatrist, Greg was stable, with no psychosis.
