Max​

• Max is a 37-year-old man who experienced his first episode of schizophrenia during his final semester of college.

• At the time, he was hospitalized due to the severity of his symptoms.

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Psychiatric History

• Symptom Onset and Progression: 15 years ago, Max began experiencing auditory hallucinations and paranoia. He believed people were conspiring against him and expressed intense fears of external threats, such as a bomb explosion. He also reported delusional thinking, including the belief that he could communicate telepathically.

• Acute Episode Leading to Hospitalization: Max was admitted after a severe episode where he ran out of his house, believing a bomb explosion was imminent. He threw a rock through his car window in an attempt to retrieve scattered pills and was subsequently taken to the emergency department.

• Functional Impairment: Max was unable to participate in academic activities and had withdrawn from his hobbies. He reported difficulty concentrating, declining social engagement, and increasing isolation.

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Social History

• At the time of his hospitalization, Max lived alone while attending college but maintained close ties with his family. He was single.

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Comorbidities

• Anxiety and depression during high school, for which he was hospitalized once

• Gastroesophageal reflux disease

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Medications

• LAI antipsychotic

• Semaglutide 2 mg subcutaneously once weekly for weight management

• Pantoprazole 40 mg daily

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Substance Use:

• Occasional recreational marijuana use (smoked)

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