CASE STUDY 3

Appendix A:

Scenarios for assessment Select only two scenarios

Scenario A – Metabolic Syndrome

Anton is a 20-year-old man who lives in a regional area. He was not very successful at school and smoked cigarettes and cannabis since age 14. He left school in grade 11 after obtaining a job as a commercial cleaner, working early shifts in a nearby town. He moved into a share house and his cannabis habit increased, as did his experimentation with party drugs. He lost his job after about 6 months due to concerns about his performance and having lost his driver’s license. He was admitted to a mental health unit sometime after with psychotic symptoms – He was paranoid, believing ‘people’ were watching his house and wanted to hurt him. He reported hearing stories about himself on the radio and television. He was diagnosed with a psychotic illness and discharged for GP follow-up on Risperdal Consta 37.5 IMI every two weeks (which is administered at a local GP surgery). He has trouble sleeping from time to time and takes up to 100mg of Quetiapine each night. Anton’s psychotic symptoms seem to have remitted. However, over the last 12 months he has become quite reclusive, spending most of his time playing on-line games or watching television. He used to enjoy cycling and surfing but says that since “getting sick” he has lost his motivation.

He is on disability pension and spends most of his spare money on tobacco and cannabis. He buys a $100 bag of cannabis each week and mixes it with tobacco before smoking it in a bong. He has put on around 15 kg over the year (height 180cm, weight 97kg). He is not happy about his weight gain but says he is not a very good cook eating mostly fried food washed down with his favourite drink high caffeine full sugar soft drink (of which he drinks up to 4 litres per day). Anton would like to have a girlfriend. His most recent relationship was with a woman whom he met on an on-line gaming chat room. They dated for a while, but he was concerned and embarrassed that he was impotent and is unsure whether he can ever be in a relationship. Anton would like to get a job, but he is unsure whether he could handle the stress and often sleeps in until late in the morning.