First-Episode Schizophrenia in a 19-
Year-Old: Paranoid Delusions,
Auditory Hallucinations, and
Academic Collapse
### Patient Bio-Data
* **Name:** Justin Johnson
* **Age:** 19 years old
* **Gender:** Male
* **Source:** Accompanied by his mother, who provides valuable
collateral information .
* **Occupation:** College student (recently expelled from an
engineering program) .
### Chief Complaint (CC)
* **Patient's Statement:** "The dean of engineering is trying to fail
me. I am NOT going to elaborate." .
* **Mother's Statement (Collateral):** "Problems at school" .
, ### History of Present Illness (HPI)
Justin is a 19-year-old male brought in by his mother due to a six-month
history of progressive behavioral and psychological changes. The onset
of these symptoms appears to correlate with his decision to
discontinue his methylphenidate, which he had been taking for ADHD,
approximately six months ago. He views the medication as an
unnecessary manipulation tactic .
His condition has led to a significant decline in functioning, culminating
in his expulsion from college two months ago. The precipitating
incident was an attempt to break into a campus building, during which
he shouted that the dean was trying to steal his "intellectual property" .
**Core Symptoms (from patient and mother):**
* **Paranoid Delusions:** Justin holds a fixed, unshakeable belief that
he is being spied on and that his inventions are being stolen by the
dean. He believes he is under surveillance and that monitoring devices
are hidden in his home. He has stated that he is "appropriately vigilant"
and that he keeps track of everything to protect himself .
* **Auditory Hallucinations:** His mother reports hearing him talk to
himself, yell, and scream in his room as if he is having a conversation
with someone, suggesting auditory hallucinations .
* **Ritualistic/Compulsive Behaviors:** He engages in repetitive
checking behaviors, such as examining door locks and windows up to 11
times a night. He searches his room for monitoring devices and covers
all electronic screens in the house .
Year-Old: Paranoid Delusions,
Auditory Hallucinations, and
Academic Collapse
### Patient Bio-Data
* **Name:** Justin Johnson
* **Age:** 19 years old
* **Gender:** Male
* **Source:** Accompanied by his mother, who provides valuable
collateral information .
* **Occupation:** College student (recently expelled from an
engineering program) .
### Chief Complaint (CC)
* **Patient's Statement:** "The dean of engineering is trying to fail
me. I am NOT going to elaborate." .
* **Mother's Statement (Collateral):** "Problems at school" .
, ### History of Present Illness (HPI)
Justin is a 19-year-old male brought in by his mother due to a six-month
history of progressive behavioral and psychological changes. The onset
of these symptoms appears to correlate with his decision to
discontinue his methylphenidate, which he had been taking for ADHD,
approximately six months ago. He views the medication as an
unnecessary manipulation tactic .
His condition has led to a significant decline in functioning, culminating
in his expulsion from college two months ago. The precipitating
incident was an attempt to break into a campus building, during which
he shouted that the dean was trying to steal his "intellectual property" .
**Core Symptoms (from patient and mother):**
* **Paranoid Delusions:** Justin holds a fixed, unshakeable belief that
he is being spied on and that his inventions are being stolen by the
dean. He believes he is under surveillance and that monitoring devices
are hidden in his home. He has stated that he is "appropriately vigilant"
and that he keeps track of everything to protect himself .
* **Auditory Hallucinations:** His mother reports hearing him talk to
himself, yell, and scream in his room as if he is having a conversation
with someone, suggesting auditory hallucinations .
* **Ritualistic/Compulsive Behaviors:** He engages in repetitive
checking behaviors, such as examining door locks and windows up to 11
times a night. He searches his room for monitoring devices and covers
all electronic screens in the house .
