John was interviewed in a psychiatric hospital after his illness came to the attention of his employers and acquaintances. He was very nervous before he was referred for treatment. He said the typical anti-psychotic medication he received back then, Thorazine, slowed him down a bit but he was pleased he was no longer anxious or uptight.

During the interview he was well spoken and calm. Indeed, without hearing him describe his symptoms, it might not be easy, after just a short conversation, to recognize that he was ill unless he mentioned his delusions or hallucinations.

Background

When John was still in high school, he was referred to a school psychologist and hospitalized for a week after he heard the voice of his recently deceased grandmother urging him to join her. He said he did not feel ill in any way and was puzzled that doctors thought he was ill.

John graduated from high school and dropped out of college after eighteen months to get married. In his mid-twenties and working as a shipping clerk, he was referred to psychiatric care after his employers noticed he was not making any sense.

About six weeks before the interview, he began hearing voices that told him he had to save other people and himself. Initially, this scared him. Although he did not know whose voices he heard, he suspected they belonged to a messenger sent by God to tell him what was happening in the world.

The voices warned him that a big war was about to begin and spread around the world. The voices told him he had to warn people. He did what the voices urged him to do.

Twice he walked out of work to go to church at the command of the voices, which told him he would receive more instructions there. He sat all afternoon in the church.

John said television and radio newscasts were like puzzles to him. They provided the pieces of the puzzle and he had to solve them. The broadcasts told him what was going to happen and what part he would play. He was absolutely certain he had a role in the events he foresaw. John said the clues — what psychiatrists call delusions of reference — are in all news programs. John could not understand why other people couldn't see what he saw in the broadcasts. He believed anyone is capable intellectually of figuring out the puzzle, but only he had been told how to do it.

During the interview, he knew where he was and what month it was but was uncertain of the year and day. Asked to keep subtracting seven starting with the number 100, he was not able to keep an accurate count after the first result, ninety-three. He remembered what he had for breakfast the morning of the interview.

Predicted Outcome

John had a common form of schizophrenia, the paranoid subtype. His chances of recovery were good and the doctor told him that in time, he would be released from the hospital, something John was looking forward to. John's post-hospitalization goals included returning to school and teaching.