BY CHITRA DEVI

CLINICAL PRESENTATION

HISTORY COLLECTION

PRESENTING CHIEF COMPLAINTS:

Informant says:• Muttering to self• Irritable • Laughing to self• Not sleeping well

Patient says:• Unable to sleep,

because while sleeping he is hearing a sound.

SCHIZOPHRENIA

INTRODUCTION: The word ‘schizophrenia’ was coined in

1908 by the swiss psychiatrist eugen bleuler. It is derived from the greek word

skhizo(split)and phren(mind).DEFINITION: “It is a psychotic condition characterized by

a disturbance in thinking,emotions,volitions and faculties in the presence of clear consciousness,which usually lead to social withdrawal”

ETIOLOGY:

CAUSES

Biological theories

Biochemical theories

Excess of dopamine

Abnormalities in neuro

transmittersNeurostructural theories

Genetic theories

Psychodynamic

theories Regressed id behaviour

Over protective and

domineering parents

Dysfunctional family

Vulnarability stress model

Stressful life event

•TYPES OF SCHIZOPHRENIA:

PARANOID

UNDIFFERENTIATED

HEBEPHRENIC

CATATONIC

RESIDUAL

SIMPLE

TYPES OF SCHIZOPHRENIA

PARANOID SCHIZOPHRENIA

DELUSION OF PERSECUTION

DELUSION OF JEALOUSY

DELUSION OF GRANDIOSITY

AUDITORY HALLUSINATION

DISTURBANCE OF MOTOR BEHAVIOUR

HEBEPHRENIC SCHIZOPHRENIA

THOUGT DISTURBANCE

INCOHERENCE

SEVERE LOOSENING OF ASSIOCIATION

EXTREME SOCIAL IMPAIRMENT

SENCELESS GIGGLING

CATATONIC SCHIZOPHRENIA

INCREASE IN SPEECH PRODUCTION

LOOSENING OF ASSOCIATION

MUTISM , ECHOLALIA

RIGIDITY , ECHOPRAXIA

NEGATIVISM , WAXYFLEXIBILITY

POSTURING

• INCREASE IN PSYCHOMOTOR ACTIVITY

• AMBITENDENCY

• STUPOR

RESIDUAL SCHIZOPHRENIA

Emotional blunting

Eccentric behaviour

Illogical thinking

Social withdrawal

Loosening of association

PAST EXPERIENCE

Prenatal exposure to viral infection

GENETIC INFLUENCE

Family history of schizophrenia Possible birth defect

PRECIPITATING EVENT

Stressful to threaten Already weak ego

Defence mechanism used are DENIAL, INDICATION,RELIGIOUSITY, RECURRECTION

SECONDARY

Unable to use coping mechanism Weak ego strength

COGNITIVE APPRAISAL(PRIMARY)

Perceived threat to self concept

EXISTING CONDITION

Abnormal brain structure , Epilepsy,

Hallucination , delusion, social isolation, violence, autism , apathy, bizzare , behaviour &inappropriate

affect

Initial psychotic episode, exacerbation of schizophrenic symptoms

QUALITY OF RESPONSE

AdaptiveMaladaptive