History of mental illness Patient

History of mental illness Patient stated at separate times: 1) that his mental illness began in his teens, and 2) that it began in his late twenties and was precipitated by drug abuse. Patient has been hospitalized six times within the last five years. Paranoia and the interaction effects of substance abuse have precipitated each of these hospitalizations. At times patient has been considered dangerous to himself and others, and has made two suicide attempts; and he has had paranoid thoughts that he must kill others to protect himself from their potentially killing him. Preceding his last hospitalization patient was aggressive and inappropriate and needed restraints when hospitalized. Diagnosis: Schizophrenia, chronic paranoid 295.30 Alcohol Dependence 303.90 Cannabis Abuse in remission 305.20 Hallucinogen Abuse (LSD) in remission 305.30 Substance abuse history Patient states that he was prescribed Tranxene for relief of acute anxiety. This prescription was renewed for eight years from the time patient was eighteen to twenty-six years old. Patient stated that he was detoxified from the drug in a Drug Rehabilitation Center. Other treatments include two two-week long rehabilitation programs. Patient began drinking alcohol at fifteen years old and began smoking marijuana at seventeen years old. Patient has a history of multi-drug abuse. Patient reports that he is unable to have just one drink. When he drinks he consumes very large quantities of alcohol. Other pertinent information Patient has a history of elopement from treatment and non-compliance with medications. Patient’s last hospitalization was one and one-half to two years. During his hospitalization there may have been some continued substance abuse. However, during the last six months of the patient’s hospitalization it was thought that the patient was abstinent, and that his abstinence was motivated by wanting to be discharged and live in the community. Present situation At the time of readiness for discharge from the hospital patient’s only family contact was with his father. Patient’s wife has begun divorce proceedings. Patient has very limited contact with his daughter after a period of no contact when he was homeless. Patient has difficulty interacting with other patients. He tends to identify with staff members and to seek their company. Patient approaches work-oriented tasks in an obsessive-compulsive manner. He is task-oriented and has competent skills in some areas. Patient reports having strong urges to drink and use drugs