Mr. T is a 21-year-old man who is brought to the ER by his mother after he began talking about “aliens” who were trying to steal his soul. Mr. T reports that aliens left messages for him by arranging sticks outside his home and sometimes send thoughts into his mind.
Upon assessment, he is guarded and often stops talking while in the middle of expressing a thought. Mr. T appears anxious and frequently scans the room for aliens, which he thinks may have followed him to the hospital. He denies any plan to harm himself but admits that the aliens sometimes want him to throw himself in front of a car, “as this will change the systems that belong under us.”
The patient’s mother reports that he began expressing these ideas a few months ago, but that they have become more severe in the last few weeks. She reports that during the past year, he has become isolated from his peers, frequently talks to himself, and has stopped going to community college. He has also spent most of his time reading science fiction books and creating devices that will prevent aliens from hurting him. She reports that she is concerned because the patient’s father, who left while the patient was a child, exhibited similar symptoms many years ago and has spent most of his life in a psychiatric hospital.
Remember to answer these questions from your textbooks and clinical guidelines to create your evidence-based treatment plan. At all times, explain your answers.
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