Ask the psychiatrist...

Can two family members have the same psychiatrist?

 

There is no reason why they shouldn’t, as long as both people are happy with that arrangement.

 

However, it’s important to remember that good mental health care often involves input from a team of professionals, not just psychiatrists. Mental health services are provided on a geographical basis and psychiatrists are attached to a clinical team that serves a specific patch.

 

Often the psychiatrist looks to team members to provide ongoing monitoring and regular feedback. As an entire team cannot change the patch they cover, the two family members would have to live in the same area.

 

If they live in different areas, changing to have the same psychiatrist might be disadvantageous if this jeopardised important teamwork. 

 

Is it possible that there is a link between psychosis and dyslexia/specific learning difficulties?

 

There is evidence that people suffering from learning difficulties are more likely to develop psychosis.

 

There are also several studies that suggest that some people with schizophrenia may find it hard to concentrate, or find the right words. The research suggests that some people experience these sort of difficulties before they develop the symptoms of psychosis. Whether these are early manifestations of schizophrenia, or whether they are related in a broader way to the risk of developing a range of other mental health problems is still uncertain. But yes, it is possible that there is a link.

 

My daughter was sectioned and no-one will tell me what happened when she was in hospital. How can I find out?

 

It may be that your daughter has explicity asked for all the details to be kept from you. If that is the case, and she is an adult, has been assessed as having capacity to make decisions, and there is no issue of safety that can override her wishes, I’m afraid there is little you can do.

 

However, these are steep criteria and things are seldom so black and white.

 

While I cannot answer for your particular case, I would say that in general, the consultant psychiatrist is best placed to weigh up these issues and to find an acceptable way of communicating important information about the care of a relative. You could try to ask your GP or your daughter’s mental health team who the consultant psychiatrist was, and then try to organise an appointment with them by ringing their secretary. The consultants for hospital wards can usually be found from hospital websites, or by ringing the hospital and asking the switchboard.

 

It is possible that no-one has asked your daughter for her view, and so a meeting with your daughter, the hospital team and yourself might be a way forward. It is worth asking the hospital team, or your daughter’s current mental health team, if she has one, for a joint meeting to discuss this. 

 

My son is concerned about going on holiday abroad in case something happens – can he get access to mental health care in other countries if he has an episode while is away?

 

It will depend where he is going. Mental health services in the major industrialised countries such as in Western Europe, North America and Australia/New Zealand are broadly equivalent to those in the UK, with a comprehensive range of drug and psychological treatments. On the other hand, services are often very basic in the ‘developing’ world. Some countries in Africa and Asia for example, have only a handful of psychiatrists for the whole country and very limited choice of medications – often only one or two antidepressants and some of the older antipsychotics.

 

Good preparation before travel is key. He should discuss travel plans with his GP and, if still in contact with mental health services, also with his psychiatrist who may be able to give more country-specific advice. Wherever he travels, he should take sufficient of his regular medication for the trip and a letter from his GP (and/or psychiatrist) outlining the nature of his condition and current treatment.

 

My son has been diagnosed with XYY syndrome – could this be causing his bipolar disorder?

(boys and men with XYY syndrome have an extra Y chromosome)

 

Possibly, but it is very unlikely to be a direct cause. There have been case reports of the co-occurrence of schizophrenia or bipolar disorder among XYY men, but these early studies had many technical problems that make it difficult to come to a confident opinion.

 

The most careful and sizeable study to date carried out in more than 1,000 individuals with these and similar sex chromosome disorders did not find evidence for increased occurrence of bipolar disorder or schizophrenia considered separately¹.

 

However, XYY children can have behavioural problems such as hyperactivity, temper tantrums, speech and language problems and other learning disabilities, some of which are linked to an increase in the occurrence of schizophrenia. So, in short, the jury is still out but with some theoretical and indirect evidence to suggest that the link is present, it would more likely to be with schizophrenia.

 

1. Mors, O., Mortensen, P.B., & Ewald, H. (2001) No evidence of increased risk for schizophrenia or bipolar affective disorder in persons with aneuploidies of the sex chromosomes. Psychological Medicine 31, 435-430

 

What’s the difference between schizophrenia and paranoid schizophrenia?

 

Paranoid schizophrenia is a sub-type of schizophrenia.

 

The term paranoid schizophrenia is used where the most prominent symptoms are of delusions of persecution or reference (seeing reference to oneself in newspapers, TV, billboards etc). Sufferers often see themselves as specially important in some way (and hence being the target of persecution). Auditory hallucinations include sinister whispering or laughter through to clear voices that mock or threaten the sufferer. Other features of schizophrenia, such as incoherence and disturbances of mood, are absent or less prominent.