Case report, painter apprentice
Fabio* was overjoyed when, at 16, he could finally leave compulsory schooling behind and step into adult life. However, he struggled a great deal to find a suitable apprenticeship. Temporary jobs at construction companies kept him afloat financially. At that time Fabio spent a great deal of time with his friends. This was how he first came into contact with alcohol and cannabis. When Fabio was at home there were often arguments with his father, who frequently accused him of being lazy and a freeloader. His mother, on the other hand, was very worried about her son, and after repeated attempts she managed to persuade him to accept help from a careers counsellor.
With the help of the psychologist working there, who campaigned enthusiastically for his professional start, Fabio succeeded in landing an apprenticeship as a painter. As his engagement with work grew, his contact with his unemployed friends and with drugs waned. He felt comfortable in his position and had a good rapport with his boss, who saw a great deal of potential in Fabio.
After the first year of the apprenticeship, however, Fabio increasingly struggled to concentrate on the material he had to learn. Recurring worries about possibly failing the upcoming exams made it hard to fall asleep at night. He became progressively more listless and lacking in drive, and found it harder and harder to keep up with the apprenticeship.
As a result, Fabio failed the exams and had to repeat the second year. His father was not pleased and reacted with hostility and rejection again. Left alone with his distress, Fabio withdrew further from family life and resumed contact with his old friends.
At work his concentration — and with it his performance — kept declining. After he began to use cannabis more heavily again, he repeatedly noticed how the paints at work changed. Red colours in particular often appeared much more intense to him and sometimes even seemed to steam.
Later on he also developed increasing mistrust towards his master painter. He had the feeling that the master was painting his thoughts with red paint and could therefore control what he was thinking. He withdrew more and more from his friends too. Sometimes Fabio heard the voice of his father or of his master, although no one else was in the room. They would say things such as that he had to study.
Shortly after his 18th birthday, Fabio heard the term “psychosis” for the first time. His mother had spoken with her family doctor, who suggested that Fabio’s problem might be a psychosis. Fabio and his mother then came to our early-detection outpatient clinic.
*Name changed