I also wonder how accurate an IQ test would be of someone who is in the middle of a schizophrenic episode. Their brain is not able to process thought correctly in that state and they can be highly disorganized. Perhaps the patient was exhibiting more symptoms when the test was administered the second time. I imagine the numbers might go back up if the patient were stable. Stability may require medication which somewhat validates the psychiatrist's point, but if this is the case it doesn't prove the lack of medication caused a permanent cognitive deficiency.