Put your knowledge and skills to the test with the case of Mr. N, a 48 year old gentleman, who has a longstanding psychiatric history involving multiple admissions to hospital for bipolar disorder, and schizophrenia. He has been tried on numerous medications, however he is often non-compliant with treatment, which results in delusions and disorganized thoughts. He has been homeless for much of his life, has cellulitis of both legs and chronic venous stasis, and has obsessive-compulsive and paranoid personality traits.
Most recently, Mr. N was arrested for possession of #cocaine, and was placed in jail where his mental status deteriorated further. He was declared incompetent to stand trial and was transferred to a psychiatric facility. He denies any suicidal or homicidal ideation, and fails to show signs of perceptual disturbances, however he does have poor insight and judgment.
What work-up do you think Mr. N requires to investigate his deteriorating mental status? What's on your differential and how would you manage this case?
"Malnourished and psychotic, and found incompetent to stand trial" by Patel R.R, Hornstra R, Munro S, and Dellenbaugh T (Current Psychiatry).
Most recently, Mr. N was arrested for possession of #cocaine, and was placed in jail where his mental status deteriorated further. He was declared incompetent to stand trial and was transferred to a psychiatric facility. He denies any suicidal or homicidal ideation, and fails to show signs of perceptual disturbances, however he does have poor insight and judgment.
What work-up do you think Mr. N requires to investigate his deteriorating mental status? What's on your differential and how would you manage this case?
"Malnourished and psychotic, and found incompetent to stand trial" by Patel R.R, Hornstra R, Munro S, and Dellenbaugh T (Current Psychiatry).
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