Psychology Case Record

Abstract

DIAGNOSTIC CLARIFICATION: UNDIFFERENTIATED SCHIZOPHRENIA, CONTINUOUS COURSE: Apparently well prior to four years, when he returned from Singapore because he could not cope with the job there. At home he exhibited disorganized behavior like wandering about places, assaulting wife without provocation or explanation, and appearing preoccupied. He did not initiate conversation with people and did not want to work. His sleep was disturbed on most days when not on medication. PERSONALITY ASSESSMENT: SCHIZOTYPAL PERSONALITY Mr.P.R has been married for the last 9yrs; however he is unable to have satisfying emotional and sexual relationship with his spouse. The wife describes him as person who likes to be alone, lacks in emotion and avoids sexual contact. She feels that he has odd behaviors like muttering to self and being socially withdrawn not initiating social contact with people. There are no clear symptoms of schizophrenia. He has been functioning well in his occupation. There is no history of any sleep disturbance. DIAGNOSTIC CLARIFICATION: SEVERE DEPRESSION WITHOUT PSYCHOSIS: Apparently well prior to 7 years, since then has repetitive, intrusive irrational thoughts that his body is emaciated and wasted. He would constantly look into the mirror each time he had this thoughts. He also had obsessive rumination about cricket, about how the shot could be played in different ways. Over the last 7years there has been marked decline in his scholastic performance with deterioration in self-care and episodes of assault behavior. BODERLINE MENTAL RETARDATION: Ms. S.B has had difficulty with academics since the beginning of schooling. She also had history of not persisting with tasks and needing constant supervision and prodding to complete tasks. For the last two years since the birth of her younger brother she has been noticed to be more irritable and adamant for minor problems. She is also slow to walk and takes longer to do simple tasks. There was no history of lack of social reciprocity and pronominal reversal. She continued to play with children much smaller than her age in spite her growing up. He had no sleep disturbances. No history to suggest psychosis. There was no history of seizures, loss of consciousness or altered sensorium. NEUROPSYCHOLOGICAL ASSESSMENT: DEMENTIA: Patient was apparently well up till 5 years back. He had been working as a police officer. Since the last 5years he had been noticed to be irritable with frequent angry outbursts. He would be very emotional and cried when speaking of subjects of spiritualism. His wife identified that he would frequently lose his belongings when he came home from duty, for the last 3years. For the last one and half year he was not able to do simple calculations while shopping and would forget the way about home. His handwriting has been gradually deteriorating over the last one year, almost illegible for the last 6months.In the last 4months he has been incontinence in urination and passing stools in inappropriate places. His sleep has been disturbed for the last 2 years