CA - Tesla crash off cliff shocked rescuers, Dr. dad arrested for attempted murder of family, Devil’s Slide, Jan 2023

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The prosecution have a gross incentive to go after people even if it's not the right thing - they aren't impartial we need to remember that- but these points they raised are very concerning:

"Two months after the near-fatal crash, while in jail awaiting prosecution, 'he was already asking why he had to take medications all the time', Davis added."

"The prosecutor countered that Patel has a history of being 'unreliable in reporting symptoms,' and tells people 'whatever he thinks will help him at the time.'"
 
investikater said:
The conflicting diagnosis is also concerning

Schizoaffective disorder VS psychotic episode during major depression
Click to expand...

That isn't really all that concerning.

Schizoaffective disorder means the psychotic symptoms are present even without depression. Depression with psychosis just means the psychotic symptoms are present when the person is depressed. Treatment for both is exactly the same so the diagnosis doesn't matter much as long as it's one of the two. We'll see what happens in this case, but if this is the legitimate diagnosis, particularly the Schizoaffective dx, then this treatment plan could work very well and actually is a novel way of reducing the burden on prisons. The whole point of prison is to protect the public from dangerous criminals. General criminality is not usually treatable outpatient. Schizoaffective disorder is. Someone with schizoaffective disorder behind bars is likely to get sub-par treatment, will likely be introduced to other harmful behaviors and substances while incarcerated, and will be taking up a cell that could be used by a hardened criminal we have to release early to prevent overcrowding. Meanwhile, if the schizoaffective patient can get suitable outpatient care (and this treatment plan sounds suitable, particulary the drug levels twice a week), then I think it's reasonable.
 
BeginnerSleuther said:
That isn't really all that concerning.

Schizoaffective disorder means the psychotic symptoms are present even without depression. Depression with psychosis just means the psychotic symptoms are present when the person is depressed. Treatment for both is exactly the same so the diagnosis doesn't matter much as long as it's one of the two. We'll see what happens in this case, but if this is the legitimate diagnosis, particularly the Schizoaffective dx, then this treatment plan could work very well and actually is a novel way of reducing the burden on prisons. The whole point of prison is to protect the public from dangerous criminals. General criminality is not usually treatable outpatient. Schizoaffective disorder is. Someone with schizoaffective disorder behind bars is likely to get sub-par treatment, will likely be introduced to other harmful behaviors and substances while incarcerated, and will be taking up a cell that could be used by a hardened criminal we have to release early to prevent overcrowding. Meanwhile, if the schizoaffective patient can get suitable outpatient care (and this treatment plan sounds suitable, particulary the drug levels twice a week), then I think it's reasonable.
Click to expand...
That's a relief, thank you for your expert input.

Are you able to explain why they disagreed on the diagnosis?

Also does Schizoaffective disorder have a young onset like schizophrenia?
Because if so I don't understand how he was high functioning enough to get through medical school?
 
investikater said:
That's a relief, thank you for your expert input.

Are you able to explain why they disagreed on the diagnosis?
Click to expand...

The two diagnoses are difficult to distinguish without knowing the patient for some time or relying on a reliable historian, such as former treaters they may have seen or medical records.

In schizoaffective disorder, the psychosis is the predominant feature. These patients can be psychotic without depression. However, anytime they're depressed, they're also psychotic. The depression is never present by itself. There are different types of schizoaffective disorders. The one he likely has (if this is the correct diagnosis) is schizoaffective disorder, depressed type.

In major depression with psychosis or psychotic depression (the latter is an outdated term), the patient can be depressed without being psychotic. But they will never be psychotic without depression playing a role.

These two illnesses represent the relationship between psychosis and mood. In one, it's the psychosis driving the pathologic mood (psychosis --> depression). In the other, it's the mood triggering psychosis (depression --> psychotic).

If they haven't known the patient long enough, then it becomes impossible to tell if the patient has ever had psychosis without depression or ever had depression without psychosis. Since the patient is likely ill when you meet them, the patient probably can't tell you (plus, they likely lack the insight to tell you). But without a reliable family member, former treater or medical records, you have no way of knowing if it's the psychosis or the depression that's the prominent "always-there" symptom without knowing the patient for some time.

investikater said:
Also does Schizoaffective disorder have a young onset like schizophrenia?
Because if so I don't understand how he was high functioning enough to get through medical school?
Click to expand...

Yes, schizoaffective disorder typically has a younger onset, but generally isn't as severe as schizophrenia can be. Don't fool yourself, there are people with schizophrenia who are extremely high functioning. These people DO become doctors, CEOs, top government officials, Nobel Prize winners (like John Nash), celebrities, legislators, teachers, lawyers, and everything in between. As a society, we're programmed to see people with schizophrenia as those who are homeless, addicted to drugs or alcohol and needing group homes to survive. In fact, there are many out there who either have a milder course of the illness or take their medications and are compliant with treatment and are able to do well for themselves. The thing is, those who are successful are very reluctant to say they have schizophrenia because of the stigma. Imagine a Fortune 500 company CEO saying it. It wouldn't happen because people would lose trust in his or her ability to run the company even if he or she has already done so successfully for years. So they keep quiet. But I promise you they exist. It's a shame that all we hear about are the ones who don't do well.
 
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BeginnerSleuther said:
The two diagnoses are difficult to distinguish without knowing the patient for some time or relying on a reliable historian, such as former treaters they may have seen or medical records.

In schizoaffective disorder, the psychosis is the predominant feature. These patients can be psychotic without depression. However, anytime they're depressed, they're also psychotic. The depression is never present by itself. There are different types of schizoaffective disorders. The one he likely has (if this is the correct diagnosis) is schizoaffective disorder, depressed type.

In major depression with psychosis or psychotic depression (the latter is an outdated term), the patient can be depressed without being psychotic. But they will never be psychotic without depression playing a role.

These two illnesses represent the relationship between psychosis and mood. In one, it's the psychosis driving the pathologic mood (psychosis --> depression). In the other, it's the mood triggering psychosis (depression --> psychotic).

If they haven't known the patient long enough, then it becomes impossible to tell if the patient has ever had psychosis without depression or ever had depression without psychosis. Since the patient is likely ill when you meet them, the patient probably can't tell you (plus, they likely lack the insight to tell you). But without a reliable family member, former treater or medical records, you have no way of knowing if it's the psychosis or the depression that's the prominent "always-there" symptom without knowing the patient for some time.



Yes, schizoaffective disorder typically has a younger onset, but generally isn't as severe as schizophrenia can be. Don't fool yourself, there are people with schizophrenia who are extremely high functioning. These people DO become doctors, CEOs, top government officials, Nobel Prize winners (like John Nash), celebrities, legislators, teachers, lawyers, and everything in between. As a society, we're programmed to see people with schizophrenia as those who are homeless, addicted to drugs or alcohol and needing group homes to survive. In fact, there are many out there who either have a milder course of the illness or take their medications and are compliant with treatment and are able to do well for themselves. The thing is, those who are successful are very reluctant to say they have schizophrenia because of the stigma. Imagine a Fortune 500 company CEO saying it. It wouldn't happen because people would lose trust in his or her ability to run the company even if he or she has already done so successfully for years. So they keep quiet. But I promise you they exist. It's a shame that all we hear about are the ones who don't do well.
Click to expand...
Wow that's amazing. Thanks very much again for your insight.

It sounds like schizophrenia and schizoaffective etc need a brave successful celebrity to be the first to come out. I know of a few things like that.
 
investikater said:
The conflicting diagnosis is also concerning

Schizoaffective disorder VS psychotic episode during major depression
Click to expand...

Very hard to distinguish. I'm surprised they didn't add Bipolar II. What's weird about this particular psychotic episode, if such it was, is that the man was apparently able to converse well enough that his wife thought he was relatively normal/okay to drive with. He drove quite a way successfully in this state.
 
10ofRods said:
Very hard to distinguish. I'm surprised they didn't add Bipolar II. What's weird about this particular psychotic episode, if such it was, is that the man was apparently able to converse well enough that his wife thought he was relatively normal/okay to drive with. He drove quite a way successfully in this state.
Click to expand...

Bipolar II doesn't usually include psychotic episodes and we haven't heard of hypomania here as far as I know.
 
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