Differential Diagnosis

My son has been treated by the Early Intervention in Psychosis team for nearly 3 years, with little success.  His case has not been straighforward and he has refused any kind of intervention, often giving monosyllabic answers but often quite articulate in defence of his own position.  This position is that he is strongly affected by what he calls "negative energy" from which he needs to protect himself via various rituals or even just escaping from "contamination."  He is withdrawn mostly, spending all his time alone in his room but not, as the CPN has recently observed "actively psychotic".  His current consultant (the fourth!) has said that he doesn't have psychosis and he doesn't have schizophrenia and she's referred him to the autism team.  I'm shocked, especially after all this time.

My son does seem to have delusional beliefs, he's withdrawn, he paces around and his self care is extremely poor.  This, to me , seemed to fit with the diagnosis of psychosis. At the same time though, I'm aware that there are other, longer standing features to this. He was referred to an audiologist as a very young child as he seemed to be hard of hearing, not responding to those around him.  He was, though, actually choosing to ignore people and remain in his own world.  He has always had what I call a "self contained" element to his personality.  And, although until recent years he has been quite sociable and able to join in very easily, he say's he's always actually felt like an outsider and that he didn't think he was ever really one of the group.

I'm finding it hard to piece things together.  He's an adult now (21) and he surely can't stay in his room forever.  What are the differences between psychosis and autism and how might a consultant differentiate.  I'm wondering what these labels mean and how they can be helpful to us in this situation.  So far I'm tired of hearing people saying that "He needs help" or "You need to get help" and the type of help not being specified.  I need to know what to do on a day to day basis to improve things. 

  

Parents
  • Former Member
    Former Member

    A score of 31 is some considerable distance from average. Other posters on the forum who have considerable issues have posted similar scores. It all depends on the environment, on the school you go to, on parents attitudes, on intelligence etc etc. Genetics means that your parents and your offspring will have different sets of genes and may have difficulties or not depending on the roll of the dice. I can trace back odd behaviour through several generations. I am much more comfortable that it can be dealt with by future generations as understanding will grow with time. It is unfortunate, but no worse than that, that your son wasn't spotted or diagnosed earlier. This is an invisible condition so it often goes unspotted.

    It is entirely possible to manage well or thrive with the condition if it is understood and if the environment can be adjusted or selected to be congenial. Your son needs to have his issues unravelled but I think that this should be entirely feasible as long as he gets the right understanding from everyone around him.

    You might like to read Susan Cain's "Quiet" book. It talks in terms of the particular strengths that intraverted people have. She also did a very good talk on TED which you should be able to find.

Reply
  • Former Member
    Former Member

    A score of 31 is some considerable distance from average. Other posters on the forum who have considerable issues have posted similar scores. It all depends on the environment, on the school you go to, on parents attitudes, on intelligence etc etc. Genetics means that your parents and your offspring will have different sets of genes and may have difficulties or not depending on the roll of the dice. I can trace back odd behaviour through several generations. I am much more comfortable that it can be dealt with by future generations as understanding will grow with time. It is unfortunate, but no worse than that, that your son wasn't spotted or diagnosed earlier. This is an invisible condition so it often goes unspotted.

    It is entirely possible to manage well or thrive with the condition if it is understood and if the environment can be adjusted or selected to be congenial. Your son needs to have his issues unravelled but I think that this should be entirely feasible as long as he gets the right understanding from everyone around him.

    You might like to read Susan Cain's "Quiet" book. It talks in terms of the particular strengths that intraverted people have. She also did a very good talk on TED which you should be able to find.

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