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Suffering from lack of interest in family. Playing only video games. Consulted physicist. No use. Suggest?

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Practicing since : 2004
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My only son is 25yrs old. He is very intelligent. He was a scholar in his school days. He was given his first computer when he was in std-III. In latter part of the school he started drifting from studies and engaging in video games. He took addmission in BE. In college days, he only played and played. He was in the college for 5 yrs and could reach 3rd year. He dropped out 2yrs back. He then wanted to persue a training course. He joined it. For two months, when his laptop was not with him in the hostel, he performed well. He completed 8mths out of 20 mths and passed 3 subjects out of 7 subjects appeared. He did not study but appeared for the examinations. When asked why without preperation he appears, his answer is "to learn 2+2=4, I need not to study". After failing, his answer was "they don't know how to check the answer sheet". Now he is sleeping for 12hrs and playing/remaining on the net for rest 12hrs. This playing is mostly at night. We are struggling to serve food in odd hours. He is taking 2 meals a day. As long as he is not objected, he is merrily pulling on. The moment he is objected, he shows anger. He is using his anger as his shield. A week back, when I requested him to visit a physhiatrist, he answered "I don't require, you require it, had it been a civilised country like US, you were to be arrested by police for child abuse XXXXXXX I have never slapped him, his mother had done a few times when he was younger. He was over-protected, over-pampered. He tells, for our over protection he has no friend and that's why he is left with video games. His friends are all away now, he has more than 100 contacts in his phone book. The games are mostly strategic games. Other than gaming, he indulges in purchasing car and gadget magazines. He reads XXXXXXX Brown and other fantasy writters. One year back when he came back home, he became very nasty for purchasing new highest end laptop and smart TV, which I had to give. His mother was very sick during that time, but he was no way concerned.
He was first taken to psychiatrist, when he failed in 1st year. MMPI was conducted and 'Axpeta-10mg' twice a day was prescribed. He refused follow up indicating lack of ambience of the place. He wants every thing high-end. The second psychiatrist also pescribed the same medicine and later on 'Inspiral'. After a few follow up, he refused taking medicine indicating 'loss of interest'. In next follow up, he showed anger to the doctor. He was prescribed 'Risnia'-1mg/ml 10 drops twice a day, which was given without his knowledge. While on this medicine for 10 days, he complained loss of control in limbs and tongue. He was addmitted in a hospital and they advised to stop 'Risnia'. A few months later third psychiatrist was consulted. 'Szetalo'-twice a day was given and aftewards, 'Olimelt' 2.5mg - once a day was given. While on this second medicine for few days, his stool became jet black. Doctor stopped the medicine, indicating it is improbale. Again treatment got discontinued. After few weeks, when he was only sleeping and gaming, his mother told him "why are you behaving like a mad fellow?" He bacame furious and forced me to take him to first phychiatrist. They told me that he came there to prove that he is not mad. They further told, there is no medicine, he is having ASPD coupled with NPD. Again after waiting for few months, I found out an homeopath, expecting homeopathic madicines would have less side effects. While on this treatment for few months, he became more violent. Doctor stopped the medicine. The last medicine given was 'Hyoscyamus Niger'. All the medicines, except a first few were given without my son's knowledge and all these times something worse happened.
Please advise me on:
1) What is he suffering from?
2) What behavioural approach I can take to correct?
3) What sort of treatments he requires?
4) A good psychiatrist in Bombay.
Posted Sat, 22 Jun 2013 in Mental Health
Answered by Dr. Ashish Mittal 19 hours later
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

You son case is difficult for caretakers and treating team. Even his attending multiple psychiatrist is facing problem to solve it. I will try to give my best effort to help you in this problem.

1) What is he suffering from?
Ans: Your son is multiple symptoms. Considering the psychological testing report, psychiatrist diagnosis and case history he may have following problem (In given hierarchy):
-PD (ASPD+NPD) with psychosis.
-PD alone

In psychosis he may have bipolar disorder (In one episode he had excessive demand), schizophrenia spectrum disorder or schizo-affective disorder. He need continuous behavior monitoring by one psychiatrist or admission for few weeks in psychiatric nursing home.

Personality disorder is a common and chronic disorder. Its prevalence is estimated between 10 and 20 percent in the general population, and its duration is expressed in decades. Persons with personality disorder are frequently labelled as aggravating, demanding, or parasitic and are generally considered to have poor prognosis.

Personality disorder is also a predisposing factor for other psychiatric disorders (e.g., substance use, suicide, affective disorders, psychosis and anxiety disorders) in which it interferes with treatment outcomes of other psychiatric disorder and increases personal incapacitation, morbidity, social complication and mortality of these patients.

Persons with personality disorders are far more likely to refuse psychiatric help and to deny their problems. Persons with personality disorders do not feel anxiety about their maladaptive behavior. Because they do not routinely acknowledge pain from what others perceive as their symptoms, they often seem disinterested in treatment and impervious to recovery.

2) What behavioural approach I can take to correct?
3) What sort of treatments he requires?
Ans: Following steps are useful in his treatment:
-Personality assessment by clinical psychologist or trained psychiatrist. It may take several days to make final diagnosis. This step has already completed in his case.
-Psychotherapeutic treatment after assessment in form of counseling, supportive therapy and cognitive behavior therapy.
-Treatment of co morbid illness like: Psychosis by antipsychotic medicines.
-Improvement may take weeks or months depending on the case.
-It is very difficult to bring these patient in treatment and treat them. It is better not to change psychiatrist on his demand, as he appear to not having insight regarding problem. It is better to visit nearby psychiatrist, so that you can approach them in need. Sometime he do not visit psychiatrist after initial visits, you can visit psychiatrist to help him.

4) A good psychiatrist in Bombay.
Ans: Nearby psychiatrist or hospital associated with Grant/ XXXXXXX G.S. medical college.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.
Wish you good health.
Above answer was peer-reviewed by
Follow-up: Suffering from lack of interest in family. Playing only video games. Consulted physicist. No use. Suggest? 2 hours later
Thank you very much for the guidance.

May I now request you to kindly delete the reports I attached. They are still available on the net and may be viewed by others.

Answered by Dr. Ashish Mittal 3 hours later
Hello again,

There is no worry, as information is confidential on this website.

Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.

Wish you good health.

Above answer was peer-reviewed by
Follow-up: Suffering from lack of interest in family. Playing only video games. Consulted physicist. No use. Suggest? 25 minutes later
If he has got PD alone, whether any medicine would work?

For the past few months, he is seldom taking to us and when talking he is very harsh. But with outsiders he is ok. How to make him to talk to us?

If you are practicing, may I have your address so that I can visit you?

Answered by Dr. Ashish Mittal 16 hours later
Hello again,

Low dose antipsychotics work in behavior symptoms of PD like irritability. In my opinion he is more likely to have psychosis too.

There is no short method to change his behavior. For improvement steps in primary reply will help, but it will take time.

For my details you can visit: WWW.WWWW.WW
Wish you good health.
Above answer was peer-reviewed by
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