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Dr. Andrew Rynne

Family Physician

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Suggest treatment for paranoid schizophrenia

Answered by
Dr. Ahmad Nazzal

General & Family Physician

Practicing since :2011

Answered : 343 Questions

Posted on Mon, 2 Nov 2015 in Mental Health
Question: My ex husband is a paranoid schizophrenic and while I understand that most patients in this category present no violent threat to others, however literature does suggest; of the small percent that do become violent, the violence is toward family. That being said we do live in different states but I'm not convinced distance matters.
1) I am interested in knowing how the threat to the greater population (negligible) differs from say, the select few that may have been the object of the patient's obsession. I.E. The Gabby Gifford shooting... (clearly not family but still represents a person who was the object of the paranoid schizophrenic's obsession)

2) While I have had no personal contact with him for years, our child, an adult, does reply to occasional text messages but prefers not to reply at all. The lack of response seems to escalate him and conversely the occasional benign replies seem to encourage his frequency of contact. Obviously we don't want to trigger him either way, by responding or not responding or just plainly telling him there is no desire to maintain contact.
Seeking answer to #1 and advise on how to handle #2,

I am not the patient - submitting questions so I have a better idea of how to handle the situation BUT your system requires Age etc... therefore I am adding what I know about patient.
Answered by Dr. Ahmad Nazzal 1 hour later
Brief Answer:
Risk is higher

Detailed Answer:
Dear XXXX,

Thank you for your question.

A series of eight studies shown that paranoid schizophrenic among other psychiatric diseases result in up to 10% acts of violence each year. MacArthur Violence Risk Assessment study the incidence of violence among treated patients was much lower than among those not taking medications. The most common victims of violence are family members, especially mothers.
Please refer to this paper for more info
''Swanson, J.W., Holzer, C.E., 1991. Violence and ECA data. Letter. Hospital and Community Psychiatry 42, 954–955.''

I guess that answers your first question. That being said It is important to understand that what you should care for is your safety and safety of your children therefore It is important not to take any violent act lightly and to report it to authorities.

Second question advise to handle: Since your child is an adult he or she can contact his or her father but again any sign of violence or intimidation or trying to drag into any kind of delusion or sign of not taking medications should be taken seriously and reported to treating doctor and contact should be avoided. On the other hand for the sake of the father recovery forming family bonds healthy ones is needed for recovery and as long as your child is an adult he or she bears responsibility on deciding how to deal with their father. There are alot of educational forums and groups to help and guide families on how to deal with schizophrenic which can provide valuable informations.

As I said before its always remember that you put your safety first and also your children too should understand that they should put their safety first.

Hope this helped.

Kind regards,
Dr. Nazzal
Above answer was peer-reviewed by : Dr. Neel Kudchadkar

The User accepted the expert's answer

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