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I. A. Identification Data

The patient is a 38-year-old married Hindu male who was brought to the hospital by his family for abnormal behavior of 4 months duration. His symptoms include overtalkativeness, decreased sleep, irritability, suspiciousness, and hallucinatory behavior. He has a history of a similar episode 4 years ago treated as bipolar affective disorder, mania. There is no significant medical, psychiatric, or family history. On examination, he was found to have pressured speech, grandiose delusions, and decreased need for sleep.

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691 views6 pages

I. A. Identification Data

The patient is a 38-year-old married Hindu male who was brought to the hospital by his family for abnormal behavior of 4 months duration. His symptoms include overtalkativeness, decreased sleep, irritability, suspiciousness, and hallucinatory behavior. He has a history of a similar episode 4 years ago treated as bipolar affective disorder, mania. There is no significant medical, psychiatric, or family history. On examination, he was found to have pressured speech, grandiose delusions, and decreased need for sleep.

Uploaded by

ilakkiya ilakkiya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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I. a.

IDENTIFICATION DATA:

NAME : Mr.

AGE : 38 yrs

SEX : Male

IP No. : 263058

UNIT : COMMON WARD

EDUCATION :

OCCUPATION :

INCOME :

MARITAL STATUS : Married

RELIGION : Hindu

DIAGNOSIS : BPAD- Mania

b. INFORMANT :

Name : Mrs. XXX

Relationship with the Patient : Wife

Intimacy and length of acquaintance : 10yr after marriage

Reliability : Reliable and adequate

II. SOURSE OF REFERAL AND REASON FOR REFERAL

Family

III.CHIEF COMPLAINTS

According to patient:

 Patient said that he has some feelings in his mind due to some debt in the family.

According to informant

 Abusive and assaultive behaviour


 Wandering behaviour
 Overtalkativeness
 Decreased sleep
 Irritability
 Restlesness
 Suspiciousness
 Overfamiliarity
 Hallucinatory behaviour

IV. HISTORY OF PRESENT ILLNESS:

Illness was acute in onset, continuous course and the precipitating factor being the non-
compliance with medication. Patient was apparently normal before 4 months, and when he
stopped taking medications, he started behaving abnormally. Since last 2 weeks his symptoms
increased and he was brought to NIMHANS on 29/ 12/ 10. This was a remission of similar
illness which occurred 4 yrs back.

Since 4 months, his sleep started decreasing and he became irritable without provocation.
He started telling that he is God, so others should come and worship him and did Poojas
excessively in day and night to increase his power. He would then ask his wife to assist in his
Poojas without dress. If wife refuse, he would abuse her physically and mentally and would
damage properties in home- TV, fan, tubelight etc. He did Poojas and threw all things into the
well telling that he has given everything to God.

He forced his wife to have sex with him more frequent than normal and would beat her if
refused. He also started telling that he is an army officer appointed by the India government for
the purpose of looking after the temples and building in his village. He would collect money
from villagers telling that he is giving it to build a temple in his land and would spend that
money to purchase things for Pooja and to eat from hotels.

He also told the family members that he was followed by many people to spy and kill
him; as they don’t want him to do good for the village. He got into frequent fights with others in
the village.

He was very active and doing various work without completing any and shifts from one
work to another. He stopped going for his regular agricultural work. He would talk to unknown
persons in a familiar manner and more than his normal. His sleep was less, inspite of this he was
very active and energetic. He would take food more than normal.
No history of over grooming, overspending, pervasive low mood, cry spells, decreased
energy, decreased interest in activities, ideas of worthlessness, hopelessness, helplessness and
suicidal ideas. No history of hearing voices in isolation and abnormal perception/ thoughts/
activities/ thoughts known to others/ being controlled by others.

V. HISTORY OF PAST ILLNESS:

Medical – No past history of any medical or surgical illness.

Psychiatric- He had a history of similar episode 4 yrs back; lasted for 3 months characterized by
delusion of reference, delusion of persecution, crying spells, depressed mood, death wishes
functioning, decreased interest in activities, decreased sleep and appetite and due to non-
compliance to medications, remitted this time.

Oct. 2006 Dec. 2010

BPAD –Mania with BPAD –Mania with


Psychotic symptoms Psychotic symptoms

 Assaultive behavior Assaultive behavior

 OvertalkativenessOvertalkativeness

 Grandiose ideas Decreased sleep

 Overfamiliarity Delusion of grandeur and persecution

 Decreased sleep Overfamiliarity

Irritability

Wandering behavior

VI. FAMILY HISTORY :

No history of any psychiatric illness in the family.


Non-consanginous marriage, no history of suicide, good social support.

VII. PERSONAL HISTORY:

Developmental record

 Mother’s condition during pregnancy: Normal


 Type of delivery: : FTND
 Type of feeding: : Breast feeding
 Weaning: : Normal
 Emotional attitude of parents: : Wanted
 Milestones: : Normal
 Any serious illness: : Nil
 Behavioural problems: : Nil

School record

 Age of beginning and finishing : up to 10thstd


 Reason for termination of studies: : Financial instability
∙ Performance of academic activities and sports: Good
 Special abilities ,hobbies and interests: Nil
 Relationship with schoolmates: : good
 Attitude towards teachers: : good
 Attitude towards play: : good attitude
 Any problems like frequent fight, truancy,
stealing, lying, gang activities : Nothing
 Higher studies type : Nil

Work record
 Jobs held : farmer

 When taken : when he has 19 yr old

 How long held : 19 yrs


 Reason for leaving : psychiatric disorder
 Financial return : 1500
 Satisfaction with work : Satisfied
 Relation with colleaques and
superiors: : Good relationship
 Work related conflicts: : Nil
 Promotion and awards : Nil
 Any war experience : Nil

Social record

 Social life and nature of relationship : Good relaionship


 Attitude towards relatives and friends: Good relationship
 Attitude towards religion and politics: Religious
 Any antisocial trends : Nil

Sexual and marital history

 Attitude towards men and women : Good attitude


 Sexual information how acquired : From friends
 Guilt and sexual fantesies : Nil
 Homosexuality or any other sexual perversions: Nil

Children

Three children- 2 female children of 8yrs and 4yrs and 1 male child of 6yrs.

VIII. PREMORBID PERSONALITY

 social relationship : Good


 Hobbies and interests : Sports
 Predominant mood : Cheerful
 Character and personality : Introvert and sensitive
 Habits and addictions : Nil

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