Читать книгу Dynamic Consultations with Psychiatrists - Jason Maratos - Страница 46

Bob is a 30‐year‐old married primary school teacher living with his wife. Bob is new to the mental health services. In early April 2018, he downloaded a new software called “FOX” on his computer, which would automatically download web pages and videos after entering a few keywords. He had entered words related to explicit sexual intercourse. He had difficulty engaging in sexual intercourse with his wife. He claimed that he did not know what videos he had downloaded.

He was reported to be mentally well until April 26, 2018 at around 5:00 a.m., when police arrived at his home and arrested him for “possession of child pornography.” He claimed that he was misled by police to confess that his computer was only used by him, although in fact it could be accessed by others (including his younger brother, wife, his wife's younger brother, and colleagues). He was brought to the police station, interrogated alone, and finally admitted the charge “under coercion.” The case was opened for investigation, and he was concerned regarding possible legal consequences including imprisonment. Since then, he had pervasive depressed mood with weeping episodes. His volition was low. He developed psychomotor retardation, was slow in actions and thoughts, with memory and attention deficits. He was socially withdrawn and preoccupied. He had increased anxiety, and described constantly being “on the verge,” with associated shortness of breath, chest discomfort, numbness of his fingers, and hand tremors. He had increased negative cognitions of worthlessness, helplessness, and hopelessness. He was admitted to the emergency ward of a medical center from April 29 to May 1, 2018, where he was seen by the visiting psychiatrist. He was given fluoxetine, diazepam, and lorazepam and was discharged. He sought help from legal advice on May 1, 2018, and the possible legal consequences were explained to him. He first attended the outpatient department on May 31, 2018, where a voluntary admission to a hospital was arranged. Since he was charged, he was suspended from duty as a primary school teacher and is on sick leave.