Treatment refusal [failed] Middle-aged female with h/o schizophrenia just had a breast lumpectomy done for breast cancer. Failed to follow-up with oncologist. Task: Hx, MSE, Mx Positives: pt stopped taking antipsychotics a while ago because she believed she didn’t need them. She also believes that the lump removed from the breast was a tracking device. She has no insight. Has paranoid delusions and auditory hallucination. No thoughts of self harm or harm to others. Mx: informed the examiner that pt most likely has relapse of schizophrenia due to medical non-compliance. I would have to involuntarily admit the patient for psych assessment and recommencement of antipsychotics. Although she is not at risk of self harm, she will be at risk of damaging important relationships (including family and oncologist follow-ups) and acting upon her paranoia. I failed to mention specifically – screen for organic cause to her acute psychotic episode, prompt referral to oncologist – I believe that’s why I failed this station
Posted on: Tue, 11 Mar 2014 08:23:04 +0000
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