Psychological Case Record

PARANOID SCHIZOPHRENIA: Mr. R, an above average student, began to fare very badly in exams during his +2 period. He complained of inability to memorise and was often noted to be lost in thoughts. His interactions with friends and later with family members declined gradually after he discontinued his studies. He also became suspicious of his own family members, frequently argued and shouted at them for minor events and later accused them of trying to kill by poisoning his food. During daytime he was found sitting alone and muttering to himself. His self care deteriorated and he grew a long beard; wore the same clothes for days together. No h/o substance abuse, seizures, head injury or LOC. No treatment to date. MENTAL RETARDATION – MILD: The patient was born of a non consanguineous marriage, full term normal delivery. Mother’s age at time of conception was 24 years and father’s age was 28 years. No history of any drug intake, fever or exanthematous eruptions in antenatal period. No antenatal checkup. No history of radiation, injury, malnutrition, vaginal bleeding. Delivery was conducted by an ayah. Cried soon after birth, breast fed after a short while. No history of neonatal seizures or difficulty in feeding. No history of jaundice. Breastfed upto 1 year. No weaning difficulties. OBSESSIVE COMPULSIVE DISORDER: According to the patient, about one year back she started to worry about her routines and started to wash repeatedly her hands and used to take bath for long hours to keep herself clean. Though she preferred to keep herself clean, she excessively indulged in these acts only in recent times. The thoughts of cleanliness occurred repeatedly as intrusive ones in her mind and got partial satisfaction only after performing these acts. This also resulted in disturbance in her work time, resulting in absenteeism and she was left feeling helpless over this issue. She kept doubting about matters like whether she had locked the door, switched off the lights and would keep checking repeatedly even though she felt it was excessive. She also had disturbed sleep at times pondering over these issues. She felt low over this problem and consulted IMH OP, and was put on Clomipramine and Amitryptiline, following which she showed improvement. No h/o hearing voices, suspiciousness. No h/o tall claims. No h/o head trauma or seizures. IPOLAR AFFECTIVE DISORDER – DEPRESSION: Ms. L was apparently normal 3 months ago, when she was noticed to be quieter than usual since changing residence, looked dull and less communicative. She felt low most of the day, did not feel like doing anything, felt intensely tired and a distinct lack of interest in doing things she used to enjoy earlier. She kept worrying over minor matters and became annoyed and irritated at the slightest provocation. She had difficulty falling asleep and maintaining sleep – got up frequently during the night. She had loss of appetite. She felt giddy, tremulous, sweating at times when she went out. She had taken an over dosage of tablets 2 weeks ago following a quarrel at home. No history of hearing voices. No history of substance abuse, head injury, fits. DEMENTIA: The patient who was brought by his sons was apparently normal till one year back. Then, his elder son noticed that the patient repeatedly searched for certain common things in the house. He would forget simple things in the house like the way for going to toilet. At times he also found it difficult to return to his house after going for a walk. In course of time, he was not able to identify his close relatives and called his son as his brother. He was not able to remember whether he had taken his food or not. His personal hygiene decreased gradually due to not taking bath and improper dressing. He would pass urine inside the house itself at times. He sleeps for very little time and would wake up in the wee hours of the night and keep pacing inside the house