This document summarizes the case history of a 50-year-old married woman with a 10-year history of schizophrenia. She exhibits symptoms like depression, irritability, suspiciousness, insomnia, hallucinations, and social withdrawal. A mental status examination found coherent thought with visual hallucinations and phobias. She has good memory and intelligence but poor judgment. The patient displays signs of delusions of persecution, jealousy, and grandiosity as well as hallucinatory voices.

1. Submitted by
Reeba Sara Koshy
&
Gurram Rakesh Varma

2. • 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

3. • 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.

4. 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

5. Types of Schizophrenia
Simple
Hebephrenic

6. 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…

8. •
PATIENT’S HISTORY
Mrs. Uma Maheswari
• 50 years
• Studied till IX th
• Married
Complaints
• Depression
• Irritability
• Suspiciousness from 2002
Associated Disturbances
• Insomnia
• Disturbances in sexual life
• History of Confusion
• Memory disturbances
• Visual hallucinations since ten years

9. Female
Male
Patient
Aged
Death

10. 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

11. 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

12. • 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

13. Good arithmetic skill
Good abstractive skills
Social Withdrawal present

14. Signs and Symptoms
According to book picture According to patient picture
Mutism (absence of speech)
Rigidity
Delusions of Persecution Thinks that her husband is cheating on her
Delusions of Jealousy Thinks that her husband is unfaithful
Delusions of Grandiosity Thinks that she has a connection with God
Hallucinatory Voices Especially when she is alone
Disturbance of affection Very low affection with husband
Disturbance of speech and motor Very low toned speech, minimal motor
behavior activity