He is waiting for his endoscopy test. His laboratory test on his clozapine evaluates an alarming low level of concentrations indicative to noncompliance of medication instructions.
The patient’s illness and behavior display. David suffers from schizophrenia with chronic positive symptoms and secondary depressive illness to uncontrolled psychotic state that needs high level care and treatment. It was recorded that he had a number of hospital admissions in a period of 20 years. He also attempted suicide in 1980’s. Few years ago he managed to be an outpatient directly under his mother’s care. His new medication, clozapine, was able to sustain him then. Lately, David believes someone is waiting to murder him due to tax he thinks he owes so he leaves his house only to collect medication and benefits scheduled twice a week. He is very sensitive to strong smells and fragrances such as aftershave, alcohol, and soap powder. He eats maximum of twice a day only because he believes someone is trying to poison his food that leads him to settle lesser food intake for mobility’s sake which resulted to detrimental weight loss. Sometimes he throws his food away of same reason. His mother observes his deteriorating mental and physical health for the past three months and requested minimal viewing of television as this contributes negative effects on him. He is getting disturbed by messages and scenes on television. Aggravated by the absence of social life or zero communications with neighbors and friends, his paranoia continues to lead him to believe death will get him any moment and complains of persistent abdominal pains and nausea which the doctor is currently trying to perform diagnosis. It maybe related to his mood. However there is no presence of illegal substance or alcohol misuse.
Healthcare. David has access to services of a Consultant Psychiatrist arranged by his psychiatric Social