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[voxprincipalis]

Dear knowledgeable forumites:

A very bright and talented student just told me that he needs to withdraw from school for health issues involving some neurological problems that doctors haven't managed to identify. They include increasing memory loss, fugue states, what he describes as OCD behavior, inability to sleep, and sometimes having thoughts in his head that don't seem to belong to him. There is some history of schizophrenia in the family, but he has not been diagnosed with it, and he says that the numerous doctors that he's seen can identify the individual symptoms perfectly well but that none of them can figure out what the cumulative diagnosis could be. It has been suggested that he might try to get seen at the Mayo Clinic or Cleveland.

I like this student a lot and would like to be able to offer him any help I can, particularly if it involves pointing him toward resources or clinics or research studies that might benefit him. If anyone has any suggestions of people or places doing research on these kinds of neurological problems, or information or contacts that I can pass along to him, I would be very grateful if you would let me know, either by posting or via PM.

Thanks,

VP

[2clueless]

I utterly hate to say this, but those symptoms fit the prodromal phase of schizophrenia or schizoaffective disorder (although individuals may move back and forth between diagnoses during their lifetime), especially with a family history. Early treatment, especially before the first psychotic episode, can make a significant difference in long-term prognosis. Mayo and Cleveland aren't places that I would recommend for psychotic disorders, actually, although either would be a good choice if it's unclear where the student's symptoms are neurological or psychiatric in nature - although schizophrenia crosses both, of course.

There are a limited number of places that have effective treatments for prodromal psychotic disorders. Mass General, UCLA, UCSF are the ones that come to mind; they each have specialized clinics for prodromal psychosis with good reputations; I imagine that they might also have referrals for resources in your local area.

Your student will be in my thoughts; I hope he's able to get the treatment that it sounds like he needs.

[voxprincipalis]

Thank you, professor_plum! I also hope he can get the right treatment; I'm really pulling for him to succeed. I appreciate both your insight and your good wishes.

VP

[frogfactory]

Thank you, professor_plum! I also hope he can get the right treatment; I'm really pulling for him to succeed. I appreciate both your insight and your good wishes.

VP

Yes - from your description he sounds clearly schizophrenic or in the prodromal phase.  However, it seems odd that doctors haven't managed to identify this - perhaps there's more/other information that complicates this diagnosis?

[voxprincipalis]

Thank you, professor_plum! I also hope he can get the right treatment; I'm really pulling for him to succeed. I appreciate both your insight and your good wishes.

VP

Yes - from your description he sounds clearly schizophrenic or in the prodromal phase.  However, it seems odd that doctors haven't managed to identify this - perhaps there's more/other information that complicates this diagnosis?

It's very possible; I shared pretty much everything here that I learned from him but I did not press him for more details. He did say that what he calls the "OCD behavior" has been going on since he was a small child, which seems to me kind of early for schizophrenia, but I'm not an expert. Oh, and he has also had apparently all kinds of MRIs and scans and such, and nothing shows up. So as professor_plum alluded to, I think they (and he) are not quite sure whether it's a mental-health issue or a neurological one, or both.

VP

[macaroon]

Vox - we have a handful of schizophrenics in my family, and I can tell you that the ones I knew as children were definitely more than a little "off" as children in a way that might net an OCD diagnosis today, and I've heard interesting stories about some of the behavior my older schizophrenic relatives engaged in as children. 

And, vox - I hate to say this, but it's probably best if the student withdraw from school.  As professorplum says, people have a better prognosis if they get treatment prior to or early into a psychotic episode.  Unfortunately, college life is a great crucible for manifesting that psychotic episode.  (Profplum - please correct me if I'm off base on this.)  There are too many large blocks of unstructured time.  Students are not discouraged from keeping irregular sleep-wake schedules.  Students with private rooms or busy roommates would be allowed to spend weeks at a time in their psychotic world with no wakeup call from the outside world.  A student can end up deeply into the episode before anyone notices anything is wrong, in a way that wouldn't happen if the individual was living with his mother and working four days a week, same time every day, at the Walmart photo center.