Is there anything more unedifying than…..

....denialists who take advantage of the severe psychosis of a juvenile to smear the reputations of scientists and economists who accurately report the implications of their research.

According to correspondence in the Australian and New Zealand Journal of Psychiatry:

Clinicians caring for psychotic patients have long noted that delusional systems are determined by ideas and beliefs to which the individual has been exposed. We describe a patient with ‘climate change delusion’, a previously unreported phenomenon.

A 17-year-old man was referred to the inpatient psychiatric unit at Royal Children’s Hospital Melbourne with an 8 month history of depressed mood, social withdrawal, school avoidance, social anxiety, amotivation, poor concentration, anhedonia, feelings of guilt and worthlessness, insomnia, suicidal ideation and self-harm. He also described hearing his own voice making derogatory and command statements, and had visions of apocalyptic events.

Admission was precipitated by acute deterioration in his condition consisting of increased emotional distress and suicidal behaviour. Prior to admission he
was treated with fluoxetine (40 mg day 1) and olanzapine (5 mg day 1). The patient had also developed the belief that, due to climate change, his own water consumption could lead within days to the deaths of ‘millions of people’ through exhaustion of water supplies. He quoted ‘internet research’ to substantiate this. The patient described that ‘I feel guilty about it’, had attempted to stop drinking and had been checking for leaking taps in his home to prevent the catastrophe. He was unable to acknowledge that the belief was unreasonable when challenged. There was no history of substance abuse. Physical examination was normal except for psychomotor retardation and superficial forearm lacerations.

The final diagnosis was major depressive disorder with psychotic features. He was treated with oral fluoxetine (60 mg day 1), clonazepam (1.5 mg day 1) and olanzapine (10 mg day 1). After several days his mood improved considerably and he denied persisting delusional beliefs. The experience of hearing his own voice persisted, but he no longer found it as distressing.

There have been numerous reports of incorporation of contemporary phenomena, such as the internet, into delusional systems, but a search of Medline and Psychlit did not identify reports of delusions related to global warming. Climate change has rapidly become a dominant issue in Australian society. A 2007 poll found that 85% of Australians were ‘very’ or ‘fairly’ concerned about climate change, significantly more than the proportion concerned about terrorism. This case provides another fascinating illustration of the cultural and environmental specificity of manifestations of psychosis.

I hope the young chap concerned is still on the road to recovery or, even better, is already there.