CNL-605 Topic 5 Case Study: Ted A single man of 40 years of age named Ted cut his carotid artery at home. He had suffered from chronic schizophrenia, dominated by paranoid symptoms, for 20 years. During his illness, Ted had spent a total of 12 years in mental hospitals; individual hospitalizations had varied in duration. While he was hospitalized, his bizarre delusions of altered body states and his experiences of being controlled by external, often invisible, agents rapidly disappeared. He had death wishes and suicidal thoughts since the onset of his schizophrenia. Death wishes also stopped soon after hospitalization. Over the years, opinion about Ted changed and his condition began to be regarded as hopeless. He was difficult to treat; he accused personnel, was unreliable, acted pretentiously, and reacted by acting out. Four years before committing suicide, he had to be transferred to another mental hospital. Two years before his death, he was transferred to a halfway house belonging to the hospital, because the staff feared that his dependence on the hospital might become excessive. After his transfer to outpatient care, his suicidal tendencies increased. Six months before committing suicide, he lost his long-term nurse. Subsequent treatment consisted of occasional office visits with a psychologist or psychiatrist. Just before committing suicide, Ted tried to enter the hospital where he had been during the initial phases of his illness. He had suffered increasingly for a few months from paranoid fears of being murdered. He threatened to commit suicide unless he was admitted to the hospital, but the threat was considered demonstrative and hospitalization was brief. The day before he committed suicide, he visited his childhood home and became afraid that a group of men had surrounded the house. He repeated his wish to enter a mental hospital. During his final night, his state changed. According to his father, Ted was exceptionally calm on the day of his death. The father said, "He no longer seemed afraid of anything." Adapted from: Saarinen, P. I., Lehtonen, J., & Lnnqvist, J. (1999). Suicide risk in schizophrenia: An analysis of 17 consecutive suicides. Schizophrenia Bulletin, 25, 533-542.