2. Case Study 1
• An adult male who was seen at a psychiatric unit complained of
hearing voices for the past 10 months and loss of appetite. He also
complained that he roamed around town, and even though he
returned home, he was sometimes physically abusive to his mother
and sister. The patient further added that he felt unsafe and thought
that people wanted to harm him.
3. The patient explained that he took a leave from work because he was
feeling feverish and asked someone to replace him, but he never
returned to the workplace. A month after commencing leave, he
received his salary for work done but subsequently was not paid by his
company. He decided to move from one bank branch to another, trying
to make withdrawals. On his third attempt at one branch, he was
arrested and put in cells for four days, but he was never given any
reason. He said he had also received death threats, one of which was a
call from an unfamiliar number. No words were spoken, but he
perceived that it was a signal that meant that his life was to be taken.
4. • His social history revealed that he lived in the city with his mother
and sister. There was no family history of mental or physical illness.
He had a premorbid personality of being introvert
5. • When the patient was first seen at the psychiatric unit, relevant signs
included complaints of difficulty in sleeping, loss of appetite, roaming
around town, and sometimes being physically abusive to his mother
and sister for the past 10 months. A mental state examination
conducted upon hospital admission revealed that the patient was
emaciated and appeared informally dressed. He exhibited
apprehensive behavior, fatuous laughter, and hesitancy.
6. • He complained of hearing voices and engaged in third person
conversations involving both a man and a woman. The patient also
complained that he heard people talking about him and insulting him,
some of whom he knew. He was therefore suspicious and felt uneasy
with others. As a result, the patient said that he had been spending
the night with a friend and refused to return to his parents’ house
because he was not safe there. He believed that he had been targeted
7. Case Study 2
A 14-year-old boy, educated up to class 6, belonging to a family of
middle socioeconomic status and residing in an urban area was brought
with complaints of academic decline for 3 years and hearing voices for
the past 2 years.
The child attained developmental milestones as per age. From his early
childhood, he was exposed to the aggressive behavior of his father,
who often attempted to discipline him and in this pursuit at times was
abusive and aggressive toward him. Marital problems and domestic
violence since marriage lead to the divorce of parents when the child
attained the age of 10 years.
8. • The following year, the child and the mother moved to maternal
grandparents’ home and his school was also changed. Within a year
of this, a decline in his academic performance with handwriting
deterioration, and irritable and sad behaviour was noted. Complaints
from school were often received by the mother where the child was
found engaged in fist fights and undesirable behavior. He also
preferred solitary activities and resented to eat with the rest of the
family. In addition, a decline in performance of daily routine activities
was seen.
9. • Over the next 1 year, he also started hearing voices. He suspected
that family members including his mother collude with the unknown
persons, whose voices he heard and believed it was done to tease
him. He eventually dropped out of school and was often found awake
till late at night, seen muttering to self, and shouting at persons who
were not around with further deteriorated in his socialization and
self-care.
10. • Non-cooperation for the mental state examination, and aggressive
and violent behavior were noted. He was observed to be muttering
and laughing to himself. His mood was irritable, his speech was
laconic (use few words), and he lacked insight into his illness.
