A case of schizophrenia refuting mind-body dualism

Abstract

Introduction: The case report depicts the complex interplay between mental and physical illness and contests the notion of mind-body dualism in medicine. It emphasises the importance of holistic management of patients and the misnomer of schizophrenia as a purely mental illness.

Patient presentation: Mr S is a 35-year-old male who presented to a South African specialist psychiatric hospital via the forensic system. He had multiple physical symptoms involving the abdominal, haematological, dermatological and neurological systems, in addition to an eight year duration of untreated psychosis with a marked decline in cognition and functioning.

Management and outcome: An extensive medical examination during his admission excluded conditions such as early onset dementia, Huntington’s disease, pellagra, Wilson’s disease, autoimmune encephalitis and substance-related complications. A definitive diagnosis of schizophrenia was made, and both physical and psychiatric symptoms responded well to the administration of an antipsychotic resulting in an eventual discharge from the hospital.

Conclusion: Mind-body dualism can result in a delayed diagnosis of schizophrenia and subsequent increased duration of untreated psychosis and other complications.

Contribution: This case emphasises the flaws of mind-body dualism, and the interplay of mental and physical illness.