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Your next patient is a 19-year-old named Jackson Greene. He’s having command hallucinations to kill himself, the first episode of such symptoms. He’s admitted to your inpatient unit, and in the course of arriving at a diagnosis of schizophrenia, he was administered the Brief Assessment of Cognition in Schizophrenia (BACS) Scale, among other baseline assessments. Routine administration of the BACS has been recommended by the American Psychological Association’s working group on screening and assessment.
It turns out that Jackson’s score on the BACS is quite low, suggesting significant compromise in executive function, working memory, verbal fluency, and attention. Is he more likely given this low BACS score to have treatment-resistant illness? If that’s the case, the result might inform how quickly you should switch from 1 antidepressant to the next or influence when you would consider clozapine. Really? We’re thinking about clozapine already?
Yes. A 2017 study found that response
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