Schizophrenia

CASE STUDY

You are working on an inpatient psychiatric unit and need to do an initial assessment of your patient Randy, who has just been admitted. He has a diagnosis of schizophrenia, paranoid type. He is 24 years old and has been attending the local college and living at home with his parents. Randy has always been a good student and participates regularly in social activities.

Last semester his grades began declining. He became very withdrawn and started to spend most of his time alone in his room. His personal self-care has deteriorated as he goes days without showering.

Prior to admission, Randy spent several weeks in seclusion. He refused to join social gatherings, isolated himself, and kept his window blinds closed.

Over the past 2 days he refused to eat, telling you, “They have contaminated the food.” As you approach Randy, you note that he appears to be talking to himself. When you talk to him, he looks around and answers in a whisper but gives you little information. He states, “They are watching me and told me not to cooperate with you.”