a case study on schizophrenia

Submitted byReeba Sara Koshy

&Gurram Rakesh Varma

SCHIZOPHRENIA

• 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

Hebephrenic

Simple

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…

CRAZY

PSYCHO

MADLOONEYPSYCHO

SCHIZONUTSO

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

Female

Male

Patient

Aged Death

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 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 behavior

Very low toned speech, minimal motor activity