Before you learn about more precise details of the early recognition of psychoses, we recommend to you to read the following two case studies. From these, you can see very well why early recognition is important.
Daniel was 15 years old when he first thought about his state of psychic health. His parents had separated two years earlier, and since then he started to withdraw more and more from his mother, his sisters and friends. He no longer had any drive, felt sad and exhausted and wanted “most of all just to be left alone”. Although he was a “sporty type” he started to smoke cannabis every day. In school, he hardly had any contact any more to his school friends, mostly he remained alone or with his “mates, who also smoke cannabis” and his achievements also became worse. With his mother, who showed concern from the start, he called on his tutor on several occasions and once on the school psychologist. They reassured him however: such behaviour could occur after separations of parents and in connection with puberty. To reassure his mother even more Daniel kept quiet about his cannabis consumption.
Shortly before his 16th birthday, after he had smoked cannabis continuously for three days, he then heard a voice for the first time. At the same time, he started feeling that other persons were looking at him in a funny way, that they knew that someone was talking to him. It struck his mother at this time that Daniel was talking to himself in his bedroom and sometimes laughed in a funny way without her understanding the cause. In the course of the next twelve months his behaviour became more and more curious and irrational. For example, he thought that other persons knew exactly what he was thinking and that they could “extract” thoughts from him.
Shortly after his 17th birthday, Daniel then heard of the term “psychosis” for the first time. His mother had discussed the matter with her family doctor, who pointed out that Daniel’s symptoms could indicate a psychosis. Daniel and his mother thereupon introduced themselves in the early recognition surgery of the university hospital in London.
Melissa introduces herself in the early recognition surgery of the university hospital in London. Melissa had been studying to be a teacher of English and history for four years when it occurred to her that her bad mood had become a permanent state. For around one year, she has found her studies much more difficult; she only attends the lectures sporadically, she can hardly concentrate any more and has not slept well for a long time now. While she has known about mood swings since her early youth, she has never experienced these as long and intensively as now. At present, however she also has a lot of stress, important examinations are imminent and her mother who suffers from a manic-depressive disorder has not been doing very well for a year. About six months ago, Melissa reports, she had the feeling for the first time that her fellow students were talking about her. First of all, she was indifferent to all of that, then however she also had the same feeling regarding strangers. In the meantime, this feeling has been so strong that she hardly leaves the house, has disconnected her telephone and thinks that surveillance cameras are built into the fire alarm boxes in her apartment. While she finds these thoughts “totally absurd”, however she can distance herself less and less from them. Recently, she reports, the fire alarm boxes were supposed to be checked; on this day, she downright “dug in” in the apartment and opened the door to nobody. In the meantime, she is so anxious that she can hardly sleep. For the case history, she reported that she had had a similar but by far not so intensive episode at the age of 17. At the time, she had been treated in psychotherapy for depressions for more than two years; the anxieties that she was being watched over and threatened by other persons were not discussed however.