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Submitted by Reeba Sara Koshy &Gurram Rakesh Varma
• Chemical imbalance that interferes with a person’s ability to think clearly, distinguish reality from fantasy, manage emotions and relate to others• First signs appear in teenage years or twenties.• Illness affects 1% of the population
• Schizophrenia victims are known to be incredibly intelligent, musically talented, and can even lead independent lives if treated properly. They are typically loners by their own choice.
Schizophrenic Disorder• One or more psychotic features during active phase ( delusions)• Somatic grandiose, religious or nihilistic delusions• Delusion or jealousy with hallucination• Incoherence with marked loosening of association• Hyperactive, disorganized
Types of Schizophrenia Simple Hebephrenic
Paranoid Schizophrenia• Delusional• Common form• Delusions of Persecution- conspired against, cheated, spied upon…• Delusions of jealousy – sexual partner is unfaithful• Delusions of grandiosity- special relationship with famous persons, God…
• PATIENT’S HISTORY Mrs. Uma Maheswari• 50 years• Studied till IX th• MarriedComplaints• Depression• Irritability• Suspiciousness from 2002Associated Disturbances• Insomnia• Disturbances in sexual life• History of Confusion• Memory disturbances• Visual hallucinations since ten years
Pre-morbid Personality• Social relations – family attachment, not with outside• Intellectual activities – Listening to spiritual songs• Mood: Calm, pessimistic, self-depreciative, unstable• Character: Easily bored, very rarely does household work Sensitive, shy, suspicious, irritable• Energy and Initiative: sluggish, fatigability, energy fluctuations• Fantasy Life: Dreams in which she spoke to God, Visual Hallucinations• Habits: No eating fads, sleeps during daytime
Mental Status Examination• General Behavior- conscious, cooperative, coherent, well- dressed, adequate eye contact, adequate rapport present• Psycho Motor Activity- Very less physical movements• Speech- Low toned, slow, longer reaction time• Thought-Phobias, Visual hallucinations
• Mood – Social withdrawal, low self-esteem• Cognitive functions- Insight is absent• Oriented to time, place, person• Attention and Concentration(Digit Span Test)• Memory – Good immediate memory Recent memory absent Good remote memory Good Intelligence Poor judgment capability
Good arithmetic skill Good abstractive skills Social Withdrawal present
Signs and SymptomsAccording to book picture According to patient pictureMutism (absence of speech)RigidityDelusions of Persecution Thinks that her husband is cheating on herDelusions of Jealousy Thinks that her husband is unfaithfulDelusions of Grandiosity Thinks that she has a connection with GodHallucinatory Voices Especially when she is aloneDisturbance of affection Very low affection with husbandDisturbance of speech and motor Very low toned speech, minimal motorbehavior activity