The Case of Ramona Williams: Losing Touch

Abstract

Onset of schizophrenia typically occurs in young adulthood. The clinician should suspect a primary psychotic illness in a young early career physician who is exhibiting a reduced ability to function in his or her role, poor self-care, bizarre or erratic behaviors, irritability, and overt delusional thoughts and/or interaction with internal stimuli. Affective illness, substance abuse, and organic etiology must be ruled out. The treatment of choice for psychosis is a combination of antipsychotic medication, cognitive behavioral therapy, and family therapy. A “wellness” component that focuses on healthy lifestyle habits is particularly important given the increased risk of relapse due to sleep deprivation and stress of medical training. Medical schools in conjunction with treating psychiatrists can destigmatize psychotic illness by providing psychoeducation and supports to doctors and doctors-in-training.