Reference no: EM133915637

Scenario

You are assigned to perform an initial assessment of Mr. John Doe, a 35-year-old who was picked up by the Mental Health Officer (MHO) after his mother reported that he had left his family home and had been living in the forest for the last two months. Joe Doe has been married for five years and has two children; a girl aged 6 years and a 10-month-old boy. He had been employed as a welder with a well-established construction company until six months ago when he was suspended for frequent absenteeism and altercations with co-workers whom he accused of trying to sabotage him.

His wife confirms that John Doe had been a good husband and provider for the first four years of marriage, but even then, was always recounting stories of his grandfather being involved in the occult and performing rituals to conjure up demonic spirits. Things changed when John Doe, who had been an amateur boxer, lost an important fight to a less skilled opponent. John Doe was convinced that his loss was due to occultic interference and could speak of little else.

As his behavior became more erratic, he stopped taking care of himself, and would go for days without bathing or changing his clothes. John Doe started to miss work and accused his wife of plotting with others to destroy his dreams and to poison him. He eventually left the family home and began wandering the streets.

As you approach John Doe you note that he seems to be conversing with someone, but the room is empty. When you enquire about it, he states: "You are working with my wife, I have nothing to say"

QUESTION

What additional  patient history information will be useful in ruling out other probable causes for Doe's behavior as a mental health nurse?