SGT UNIVERSITY

BUDHERA,GURGAON

CASE PRESENTATION
ON
SCHIZOPHRENIA

SUBMITTED TO:- SUBMITTED BY:-

IDENTIFICATION DATA:
 NAME OF PATIENT : Mrs. Urmila
 AGE : 50years
 EDUCATIONAL STATUS : Graduate.
 RELIGION : Hindu
 OCCUPATION : Housewife
 ADDRESS : Sant nagar, Amritsar
 MARITAL STAUS : Married
 DATE OF ADMISSION : 25\01\23
 DIAGNOSIS : Schizophrenia ( F-20)
 DOCTOR : Dr. Savinder singh

INFORMANT:
NAME : Mr. Vikas
AGE : 55Years
RELATION : Husband
RELIABLITY : Reliable
Informant lives with patient since 27years and he is reliable for the patient’s history
CHIEF COMPLAINTS:-
( According to patient):-
 Mere kuch bhi karane ni mann ni karda aur mereko baat baat par gussa aa jaata h
aur Meri puri nhi hoti h aur pura sareer dard krta rhta h.
(According to Informant):-
 Ye kuch kaam nhi krte aur chote baayo mn gussa krte hn

HISTORY OF PRESENT ILLNESS:

PRESENT MEDICAL ILLNESS:
 Patient is having no medical illness presently.

HISTORY OF PRESENT PSYCHIATRIC ILLNESS:

 Duration of present illness : 10 Years
 Mode of onset : Insidious onset.
 Precipitating Factor : Unknown.
On the 5th december 2021, patient’s mother had a major heart attack, she was brought to the
hospital but she died. Patient left alone in his house after death of her mother. So, at that time,
in grieving period, she started wandering here and there. She started feeling lonely. His
mother and father brought her to hospital for treatment. On 4thJanurary 2021 client had
experienced some voices of unknown persons saying her to kill her family members. She
ignored but same sounds repeatedly disturbed her. Later on she also experienced that
someone is controlling her and telling her to kill her family members. Patient says that she
was experiencing the same things for 15-16 days. Then the sounds changed and they started
telling her to kill herself. After that she started isolated her from family and speaking to
herself only. She also started speaking very rapidly. From last 4-5 days the condition of
patient get worsen so, she is been taken to hospital by family members.
PAST HISTORY:-
PAST MEDICAL HISTORY:
Patient is having past medical history of dog bite 15 days back. She had taken all injections
on time of dog bite. Patient is not having history of diabetes, hypertension or other medical
conditions.
PAST SURGICAL HISTORY:
There is no past surgical history.
PAST PSYCHIATRIC HISTORY:
Patient is having no psychiatric history in past.
FAMILY HISTORY:
Type of family : Nuclear family.
Total number of family members : 2 members.
FAMILY HISTORY:-
Family chart:

SR. NAME RELATION AGE EDUCATION OCCUPATION HEALTH

NO. OF WITH STATUS
PERSON PATIENT
1. Mr. Father ------ -------- --------- Died
basant
ram
2. Mrs. Mother ------ --------- --------- Died
satya
3. Mr. Brother 45 B.A. Pass Private job Healthy
Sandeep years
4. Mrs. Patient 50 Graduate Housewife unhealthy
Urmila years
5. Mr. vikas Husband 55 Graduate Govt.employee Healthy
years
6. Mr. vinay Son 20 -------- Student Healthy
years

RELATION WITH FAMILY MEMBERS:

Patient is having healthy relations with all family members.
There is no history of any aggression or fight with family members.

Treatment :-

SR NAME OF CHEMICAL DOSE FREQUENCY ROUTE ACTION

NO. MEDICINES NAME
1. Tab. Serenace Haloperidol 0.25mg TDS Oral Typical
antipschotic
2. Tab. Aciloc rantidine 150 mg bd Oral Antacid
3. Tab. Muti- 10 mg BD Oral Vitamin
Multivitamin vitamin supplement
4. Inj.thaimine Multi- 50 mg OD IM Vitamin
vitamin supplement
PERSONAL HISTORY
BIRTH HISTORY:-
• Patient is having normal birth history.
• Patient is born with normal vaginal delivery.
• There is no history of any birth anomaly or birth defects.
• Patient is breast fed for 1 year of age then he started bottle fed.
• Other information regarding patient’s birth is not known to informant and patient itself.
CHILDHOOD HISTORY OR EARLY DEVEOLPMENT:
• All milestones are achieved at accurate time.
• Patient explained that he is having nightmares during childhood period. She got
scared of all those scary things.
CHILDHOOD BEHAVIOURAL PROBLEMS:
Neurotic traits like thumb sucking, bed wetting is not present in the patient. More history
related to patient’s childhood is not known to informant and patient self.
PLAY HISTORY: There is no significant history about patient’s play characters.
 Type of play : Patient always plays in group.
 Behavior during play : Patient is cooperative and adjustive during play.
 Relationship with playmates : Patient is friendly with his playmates.
 Personality during play : Patient is cooperative and helping during play.

SCHOOL HISTORY:
 Age of beginning school : Patient started school at the age of 5 years.
 Behavior in school : Patient is cheerful and adaptive in school.
 Relation with schoolmates : She is having friendly relation with the Classmates.
 Relation with teachers : Patient is having satisfactory relation with
 teachers. She is always obedient to teachers and follows their commands.

ADOLESCENT HISTORY:
Relationship with peers: Patient was having good relations with peers.
She explained that he got very good friends during her adolescent period.
PUBERTY:
 Age of appearance of secondary sexual characters : 13 Years.
  Reaction towards puberty: During appearance of secondary sexual characters, she got
anxious but later on he understood the facts and his anxiety goes down to normal.
Patient is having normal changes in behaviour after puberty begins. She is not much
anxious.
OCCUPATIONAL HISTORY:
Age of starting job : never worked .
Type of job : Patient is a housewife
Behaviour at workplace : Patient’s behavior is satisfactory .
There is no history of leaving the job and starting the new.
MARRITAL AND SEXUAL HISTORY:
Type of marriage : Arranged marriage.
Age at marriage : 24 years.
Behaviour with partner : Patient was having good and adaptive behaviour with partner.
Total years of marriage : Patient was married for 25 years after that her husband died due
to heart attack.
Use of contraceptives : There is no clear information about temporary contraceptives.
Number of children : Patient is having one child only.

PRE-MORBID PERSONALITY:
This is the personality and behaviour of patient before his illness.
SOCIAL RELATIONS:
Patient was having satisfactory relations with his family members, friends and workmates.
HOBBIES:
Patient likes to play ludo in his free time. she loves to watch old Bollywood movies
PERSONALITY CHARACTERICTIS:
Patient was loving, kind, optimistic, determined and cooperative. she loves and cares for his
child.
TEMPERAMENT:
Patient was cheerful and happy before illness.
ADDICTION AND HABBITS:
Patient was not having any addiction of smoking and drinking.
HABITS:
• Eating pattern : Regular eating pattern
• Sleep Pattern : Regular sleep pattern before having illness.

MENTAL STATUS EXAMINATION(MSE)

GENERAL APPERANCE

❖ FACIAL EXPRESSION: Facial expressions of patient are appropriate to and

consistent with the subject. Patient is having blank and vacant gaze during
conversation.

❖ POSTURE: Posture of patient was normally relaxed.

❖ MANNERISMS: Patient was not having repeated small movements of habitual kind
under stress.

❖ DRESS: The patient is having dress with normal neatness. He is wearing dress
according to season and occasion.

❖ HYGIENE: Patient was clean, his hair combed and finger nail were cut.

❖ PHYSICAL FEATURES:
Her features are:

❖ She is having normal weight.

❖ She looks according to his age.

❖ she is not having any physical deformity.

Inference: No abnormal appearance
MOTOR DISTURBANCES
a) OVERACTIVITY OR HYPERACTIVITY: Patient was having restlessness and
hyperactivity during conversation.
b) UNDERACTIVITY: Patient was not having slowing down of activity and functions
during conversation.
c) STUPOR: Patient was not motionless at all down of activity and functions
during conversation.
c) STUPOR: Patient was not motionless at all during talk.
d) STEROTYPY: It is of two types:
❖ STEROTYPY ACTION: Patient was not having any repetition of physical
activity.

❖ STEROTYPY SPEECH: Patient was not having any repetition of speech.

COMPULSIVE MOVEMENTS OR COMPULSIONS:
QUE: Aapko koi kaam baar baar krne ka mann krta hai jisko baar baar krne ki
jarrurat nhi hoti?
ANS: Nhi mujhe ese koi khyal nhi aate h.
OUTCOME: Compulsive movements were absent in patient.
ECHOPRAXIA: Patient was not having any pathological repetition by imitation of
movement of another person.
NEGATIVISM:
QUE: Kya aap apne bed se uthoge?
ANS: Haan, main uth jaata hu.
QUE: Kya aap aapne haath upper uthaoge?
ANS: Haan, main utha deta hu.
OUTCOME: Negtivism is absent in the patient.
AUTOMATIC OBEDIENCE: Automatic obedience was absent in the patient.
WAXY FLEXIBLITY: Waxy flexibility is absent in the patient.
Inference: No abnormal motor movements
G. DISORDER OF THOUGHT:
There are three aspects of disorders:
d) Disorder of form of thought.
e) Disorder of content of thought.
f) Disorder of progression of thought.
g) Disorder of speech.
c) DISORDER OF FORM OF THOUGHT:
ix. Circumstantiality:
QUE: Aapne aaj subh kya khaya tha?
ANS: Mene parantha aur daliya khaya tha.
OUTCOME: Circumstantiality was absent in the patient.
x. Incoherence:
QUE: Aapke ghr me total kitne log rhte hai?
ANS: Mere ghr m mujhe milakr ke pue 2 log
OUTCOME: Incoherence was absent in the patient. Patient’s speech was not having any
disorganization.
xi. Irrelevent:
QUE: Aap kya kaam krte ho?
ANS: Main painter hu.
OUTCOME: Irrelevence was present in the patient.
xii. Neologism: Patient was not having neologism. She was not coining the new words
or language.
xiii. Tangential thinking: Tangential thinking was absent in the patient. She was
giving reply appropriately.
xiv. Word salad: Word salad was not present in the patient. His sentences and words
are connected and are not mixed- up.
xv. Perseveration: Perseveration was not present in the patient. Patient was not
having any involuntary and morbid repetition of word or idea.
xvi. Ambivalence or ambivalent ideas:
Ambivalence ideas were absent in the patient.
Inference: Irrelevance of thought is present
EVALUTION OF SPEECH:
• Intensity: Patient’s voice was normally audible.
• Pitch: Pitch was appropriate to the content and doesn’t show any much change.
• Speed: Patient spoke at higher rate of speed.
• Spontaneity: Patient answers are spontaneous.
• Manner: Patient’s manner of speaking was relaxed.
• Reaction time: Patient’s reaction time was appropriate. He answers the questions at
appropriate time.
Inference; No abnormal speech problem
d) DISORDER OF CONTENT OF THOUGHT:
vi. DELUSIONS:
o Persecutory delusions:
QUE: Aapko esa lagta h ki koi aapko maarne ki kosish kr rha h?
ANS: Nhi mujhe koi maarne ki kosis ni kr ra h.
OUTCOME: Persecutory delusions were absent in the patient.
o Delusion of reference:
QUE: Aapko kabhi esa lagta hai ki log aapke bare m baat kr rhe h?
ANS: Haan, log hmesha mere bare hi baate krte hain.
OUTCOME: Delusion of reference was present in the patient.
o Delusion of influence or passivity:
QUE: Apko esa lgta hai ki koi sakti aapko vash me krke rkhi hai aur aapke dimag
aur sareer ko control kr rhi h?
ANS: nhi, mujhe esa nhi lagta.
OUTCOME: Delusion of influence was absent in the patient.
o Delusion of sin or guilt:
QUE: Aapko esa lagta hai ki aapne bhut bda gunah kiya h jiski saja ab aapko mil rhi
h?
ANS: Nhi, mene koi gunaah nhi kiya h.
OUTCOME: Delusion of sin or guilt was absent in the patient.
o Hypochondrical delusion:
QUE: Kya aapko esa lagta hai aapko esi bimari hai jo kabhi thik nhi ho skti?
ANS:Mujhe koi esi bimari nhi h. Main bilkul thik hun.
OUTCOME: Hypochondrical delusions were absent in patient.
o Delusion of grandeur:
QUE: Kya aapko esa lagta hai ki aap bhut balwaan aur saktishaali hai aur aapke paas
bhut paisa hai?
ANS: Nhi mere pas koi skti nhi h aur na hi jyada paisa hai.
OUTCOME: Delusion of grandeur was absent in the patient.
o Nihilistic delusion:
c. Depersonalization:
QUE: Kya aapko esa lagta hai ki aap badal gye ho aur aap ho hi nhi?
ANS: Nhi, esa kuch nhi h.
OUTCOME: Depersonalization was absent in patient.
d. Derealization:
QUE: Kya aapko esa lagta hai ki aapke aas pas ki dunia khtm ho gyi hai ya sab kuch
badal gya hai?
ANS: Nhi ese nhi hai.
vii. OBSESSIONS:
QUE: Koi ese khyal jo aapko baar baar mann mein me aate ho aur jinko pura krne
ke liye mann bechain hota hai?
ANS: Nhi khyal merko baar baar nhi aate hai.
OUTCOME: Obsessions are absent in the patient.
viii. PHOBIA:
QUE: Kya aapke man me kisi cheez ka esa darr h jiske bare mein sochne se bhi
aapko pareshani hoti h?
ANS: Nhi mujhe koi esa darr hi hai.
ix. PREOCCUPATION:
Preoccupation was absent in the patient.
x. FANTASY:
o Creative:
QUE: Aap hospital se discharge hone ke baad kya karoge?
ANS: Main ghar jaunga aur phle jaise hi rhungi
QUE: Kuch kaam suru kroge ?
ANS: Mujhe paint ka kaam aata hai. Main whi suru krunga.
OUTCOME: Creative fantasy was absent.
o Day dreaming:
QUE: Kya aapko esa lagta hai ki aap sawarg mein hain aur aapke pas bhut costly
cheezen hain?
ANS: Nhi, mere paas to kuch ha hi ni.
Inference: Delusion of refrence was present
e) DISORDER OF PROGRESSION OF THOUGHT:
i. Pressure of speech: Pressure of speech was absent in the patient.
ii. Flight of ideas: Flight of ideas was not present in the patient.
iii. Retardation: Retardation of speech was present in the patient during conversation.
iv. Mutism: Mutism was absent in the patient.
v. Aphonia: Aphonia was absent in the patient. Patient speaks in audible manner.
vi. Thought block: Thought block was absent in the patient.
vii. Clang association: Clang association was absent in the patient. Patient replies in
simple sentences.
Inference; No abnormal progression of thought
D) DISORDER OF PERCEPTION:
c) Illusion:
QUE: ye kya hai( pointing towards pencil.)
ANS: ye pencil hai.
OUTCOME: Illusion was absent in the patient.
d) Hallucinations:
o Auditory hallucination:
QUE: Kya aapko koi esi aawazein sunai deti hai jo aapko kuch krne ko bolti
hai?
ANS: Hain mujhe bhuto ki aawanzein sunai deti hain. Par mujhe wo aawazen
saaf pta ni chlti ki wo bol kya rhi h.
OUTCOME:Auditory hallucinations are present.
o Visual hallucination:
QUE: Kya aapko kabhi esa lagta hai akele kamre me aapke alawa bhi koi aur
hai?
ANS: Haan, mujhe esa lagta hai mere bhai ki saas mere sath kamre m hi rhti h.
par wo mujhe kabhi kabhi hi dikhti hai.
OUTCOME: Visual hallucinations are present in the patient.
o Olfactory hallucination:
QUE: Kya aapko koi esi smell aati hai jo whan kisi aur ko nhi aarhi hoti ya koi
esi khushboo ya badboo aati ho?
ANS: Nhi esi koi smell nhi aati.
OUTCOME: Olfactory hallucinations are absent.
o Gustatory hallucination:
QUE: Kya aapko kabhi kabhi kuch alag sa taste muh me aata tha jab aapne kuch
ni khaya hota tha?
ANS: Nhi.
OUTCOME:Gustatory hallucinations are absent.
o Tactile hallucination:
QUE: Kya kabhi aapko esa lagta hai ki aapke body par kuch chl rha hai ya reng rha hai?
ANS: Nhi mujhe esa nhi lagta.
OUTCOME: Tactile hallucinations are absent.
o Lilliputian hallucination:
QUE: Is pen ka size kitna hai?
ANS: Ye pen to bhut 10 c.m. hoga.
OUTCOME: Lilliputian hallucination was absent.
Inference; Auditory and visual hallucination are present
E) DISTURBANCES IN AFFECT

➢ INAPPROPRIATE OR INCONGRUENT AFFECT:

a) MOOD: Patient was having mood according to the situation. Patient was happy at the
time of conversation.
b) AFFECT: Patient was having smile at the time of conversation. She was responding
according to the conversation.

➢ PLEASUREABLE EFFECT:
a) EUPHORIA: Euphoria was absent in the patient.
b) ELATION: Elation was absent in the patient.
c) EXLATATION: Exlatation was absebt in patient.
d) ECTASY: Ectasy was absent.in the patient.

➢ UNPLEASUREABLE EFFECT:
a) DEPRESSION: Patient was not depressed during conversation.
b) GRIEF OR MOURNING: Patient was not in grief state.
➢ OTHER AFFECTS:
Patient was not having any other afeect like anxiety, fear, agitation, apathy, aggression
or mood swings.
Inference: Patient mood happy is congruent with the affect.

F) DISORDER OF MEMORY:
d) IMMEDIATE MEMORY:
QUE: main aapko 5 chizo ke naam bta rhi hu.(santra, kamiz, pencil, bed, mug).
Aap in chizo ko dohrao?
ANS: Santra, kamiz, bed pencil.
OUTCOME: Immediate memory was partially good.
e) RECENT MEMORY:
QUE: Kal raat ko aapne kya khana khyaya tha?
ANS: Mene kal raat ko kaddu ki sabzi aur chappati khaya tha.
OUTCOME: Recent memory was good.
f) REMOTE MEMORY:
QUE: Aap ki janamdin kab hota hai?
ANS: Mera janam din 15 January ko aata h.
QUE: Aapke papa ki death kb hui thi?
ANS: Unki death 9 saal phle hui thi.
OUTCOME: Remote memory was good.
DISORDERS OF MEMORY:
 Amnesia: Amnesia was not present in patient.
 Paramnesia: Paramnesia was not present in the patient.
 Antegrade amnesia: Antegrade amnesia was absent in the patient.
 Retrograde amnesia: Retrograde amnesia was not present in the patient.
l) Deja vu:
QUE: Kya aapko kabhi esa lagta hai ki kisi chiz ya kisi aadmi ko jisko aap phlli baar
mil rhe h, unko aapne phle kabhi dekha hai?
ANS: Esa kuch nhi hota mujhe.
OUTCOME: Dija vu was absent in the patient.
m) James vu:
QUE: Kya aapko kabhi kisi sthithi me esa lgta ha ki aap ne esa phle kabhi nhi mahsoos
kiya par asal me aapke sath wo sab kuch hua hota ha?
ANS: Nhi mujhe esa nhi lagta.
OUTCOME: James vu was absent in the patient.
n) Hyperamnesia: Hyperamnesia was absent in the patient.
G) ORIENTATION
TIME:
QUE: Aaj kon sa din hai?
ANS: Aaj sanibaar hai.
QUE: Aaj date kon si hai?
ANS: Aaj 15 feb tarik hai.
QUE: Abhi kon sa year aur mahina chal rha hai?
ANS: februry mahina chl rha h aur saal 2024 h
OUTCOME: Patient was fully oriented to time.
PLACE:
QUE:Aap khan rhte ho?
ANS: Main sita pur se hu.
QUE: Wha se yha aane me kitna tym lgta hai?
ANS: Karib 40 minutes lag jaate hai?
QUE:Aap nakoder se yha kese aaye the?
ANS: Mein bike par bhai ke sath aayai hu.
OUTCOME: Patient was fully oriented to place.
PERSON:
QUE: Kal apse milne kon aaya tha?
ANS: Mujse milne meri bhabhi aur bhai aaye the.
QUE: Aapke sath abhi hospital me kon hai?
ANS: Meri mmi hai.
OUTCOME: Patient was fully oriented to person.
H) INSIGHT:
QUE: Aap hospital kyu aaye ho?
ANS: Mujhe mera bhai le aaya. mujhe kuch nhi hua hai. Main ek dum thik hu.
QUE:Aap bimar kese hue ho?
ANS: Mujhe nhi pta.
QUE: Aapko lgta hai ki aap thk ho jaoge?
ANS: hain, main thk ho jaunga.
QUE: Aapko yha kya kya treatment mil rhi hai?
ANS: mujhe dwai aur injections milte hai ro. Subh aur shaam ko.
OUTCOME: Insight of the patient was partially poor.
Inference; No abnormal findings
I) CONCENTRATION:
QUE: 100 me se 7 ghtao aur ese hi 6 ghtate jao?
ANS: 93..phr, 86, 79, 67, 60.
Inference: Concentration of patient was poor. He was not able to concentrate
properly on problem.
J) ABSTRACT THINKING:
QUE: Table aur chair me kya smanta aur difference hai?
ANS: Dono par baithte hai
QUE: Santra aur ball me kya smanta aur difference hai?
ANS: Dono gol hote hai. Par ball se hum khlte hai aur sntra khane k liye hota
hai.
QUE: “Door ke dhol shuwane” is muhware ka matlb btaye?
ANS: door se kuch mousm shuana hai. Main thodi der baad btati hu.
OUTCOME: Abstract thinking of the patient was not completely concrete and
specific thinking was not appropriate.
K) JUDGEMENT:
1. PERSONAL JUDGEMENT:
QUE: Aap discharge hone ke baad kya karoge?
ANS: Kuch ni krungi main. Ghr me hi rhunga.
OUTCOME: Personal judgement was poor in the patient.
2. SOCIAL JUDGEMENT:
QUE: Agr aapko khin par ek chitti milti hai jisme address likha ho to aap kya kroge?
ANS: Address pr bhej dungi.
QUE: Agr abhi yha aag lag jaayegi to aap kya kroge?
ANS: Main aag bhujane lagungi aur fire brigade walo ko bula dungi.
OUTCOME: Social judgement was good in the patient.
L) INTELLIGENCE:
QUE: India ke prime minster kon hai?
ANS: Modi ji.
QUE: India ki rajdhani kon si h?
ANS: Delhi.
QUE: 850 me se 700 minus krke kitne rhenge?
ANS: 500 rhenge.
QUE: Jo main bolungi use ulta dohrana 9-8-7-6-5.?
ANS: 9-7-6-5.
OUTCOME: Patient’s intelligence level was good.
.
M) GENERAL OBSERVATIONS:
Patient wakes up at 7 o’clock in morning. Then she is having daily morning
activity including brushing of teeth etc. she takes his medicine at 9:30 a.m. before that she
offers prayer to the God and some exercises. At afternoon around, 1:30 pm she took his
lunch. Then she took some rest in evening. In evening she do some walk in ward only for
some time. Then she took her dinner at 9:00 p.m. then, she took his night medicines and
go to sleep at 10:00 p.m.
Patient is observed for the fits, epilepsy, impulsiveness, aggressiveness and hysteria. He
was not having such kind of activities or any other associated conditions.
SUMMARY
Mrs. Urmila 50yr female admitted in psychiatry ward and mental status examination was
done and she is was having irrelevant thought, delusion of reference and visual and auditory
hallucination are present in the patient.
 DISEASE CONDITION
DEFINITION
 Schizophrenia refers to a group of mental illness characterized by a specific
psychological symptom leading to disorganization of the personality of an individual.
 A group of disorder which is characterized by disturbance of thinking, mood and
Schizophrenia refers to a group of mental illness characterized by a specific
psychological symptom leading to disorganization of the personality of an individual.

INCIDENCE
Globally, there are 24 million people with schizophrenia or 1 out of 300 individuals in every
country. This amounts to 0.32% of the worldwide population. Among young adults, 1 out of
every 222 individuals, or 0.45% of the global population, have schizophrenia.
TYPES
 Paranoid schizophrenia
 Hebephrenic /disorganized schizophrenia
 Catatonic schizophrenia
 Undifferentiated schizophrenia
 Residual schizophrenia

ETIOLOGY
BOOK PICTURE PATIENT PICTURE
 Trauma Trauma of mother heart attack
 Stressful life events Stress
 Hormonal imbalance Hormonal imbalance
 Social factors Isolated from society
 Biochemical theories Altered level of neurotransmitters

CLINICAL FEATURES
BOOK PICTURE CLINICAL PICTURE
 Delusions Delusion of reference is present
 Hallucination Visual and auditory hallucination present
 Disorganized thinking Cognition level is impaired
 Abnormal motor behavior
 Attentional impairement
 Anhedonia Lack of motivation present
 Alogia
 Avoilition
Course and prognosis
After long-term follow-up half of people with schizophrenia have a favourable outcome
while 16% have a delayed recovery after an early unremitting course. More usually, the
course in the first two years predicted the long-term course. Early social intervention was also
related to a better outcome. The findings were held as important in moving patients, careers
and clinicians away from the prevalent belief of the chronic nature of the condition .
MEDICAL TREATMENT
BOOK PICTURE CLINICAL PICTURE
Clozapine Haloperidol
Risperidone Inj. thaimine
Chlorpromazine Tab. pantop

Other treatment
1. Identify and treat the underlying medical disorder or cause(s),
2. Manage behavioural disturbances.
3. This involves optimizing oxygenation, hydration, nutrition, electrolytes/metabolites,
comfort, mobilization, pain control, mental stress, therapeutic medication levels, and
addressing any other possible predisposing and precipitating factors that might be disrupting
brain function.
Nursing management
• Provide safe environment
• Keep patient calm and well illuminated
• Remove all the terrifying unrealistic world which increase the hallucination, illusion.
• Alleviating patient fear and anxiety
• keep the room well lighted especially at night.
• As much as possible have the same person all the time by the patient bedside.
• Meeting the physical needs of the patient
• Maintain intake and output.
• Observe the patient for extreme drowsiness
• Personal hygiene should be taken properly.
• Facilitate orientation
• Repeatedly explain the patient where he or she is.
• Have a calendar and clock in the room.
• When the acute stage is over take the patient out and introduce him to other.
REFERENCES
 Stuart W. Gail. Principles and practice of psychiatric nursing. 9th edition
 Mohr k. Wanda. Psychiatric-mental health nursing. Eighth edition
 Townsend C. Mary. Psychiatric mental health nursing Concept of care in evidenced-
based practice, 9th edition, published by jaypee brothers.