Introduction:-
My Patient name is mor maruti malgade he is admitted in
male ward at Govt. Hospital Durg with the complain of aggressive
Behaviour & Decreased sleep and irritability.
Identification Data:-
Name- Mr-maruti madgade
Age- 21 your
Sex- male
Father- Pandit malgade
Address- Bijapur,Chhattisgarh
Education- B.A.
Marital status-unmarried
Occupation- student
Income unemployed
Religion - Hindu
informed -father
Information: Relevance & Adequate.
Diagnosis Schizophrenia.
Definition:- Schizophrenia. is a chronic, severe mended disorder that
affect the way a person think aid: expresses emotions perceives reality
and relate to others. Though Schizophora isn't a common as other
major mental illness it can be most Chronic & destabilizing.
* Schizophrenia is psephitic condition charactered by a disturbance in
drinking. emotions. condition and fatalities in the presence of altar
consciousness which usually leads do social withdrawal
(Acc to R.
Shreevani)
PERSONAL HISTORY:-
A) Perinatal History-
Antenatal period - No any infection
Indra natal period - Normal delivery of Home
Birth Fuld derm
Birth Gry-Immediate,
Birth defeats. No
Postnatal complication-No
B) child hood Mistory:-
Primary caregiver - Mother
fooding - Breastfed.
Age at weaning. 6 month
developmental milestone - Normal
Behavior & emotional problem-No
Illness during childhood.- No
C) educational History:-
His formal education begins at the age of 7 year his academic &
extracurricular activity or program was poor (not interested to in value
in any activities & program ). His relationship with peers & teacher
was not good. he has no ang school phobia & ho any conduat
disorder. Rason for termination of study was not interest to
gone for study, after that 7th class he 03 not gone for school.
D) Play History:-
He was not interested to play any indoor & outdoor games. but some
time he play lakhati (Kancha goli) game.
E) Emotional problem during adolescence:- No mas no any emotional
problem during adolescence.
f) Occupational History: He has no any permanent Job. But he was
Shepherd. & grazing his goat.
G) Sexual & marital History:- my patient marriage was
concengenious, married arrange marriage again their wills.
his mother has expressed- other females. would call him for one night
stand. with money because his wife has EMA. he spoken one phone
that he wild pay 500- for sexual matters.
Mental status excamination.
General appearance & Behaviour.
Appearance - Patient looking one's age
Facial expression-Blunted
Level of grooming- Normal
Level of cleanliness-Adequate
Lovel of consciousness- fully conscious.
Made of entry-come willingly
Behaviour- Normal
Co-operativness-Normal
eye to eye contact-Maintained
psychomotor activity- Normal
Repport- spontaneous.
Gesturing- Normal
Posturing-Normal
Other movement – Normal
Hallucinatory Behaviour- absent
SPEECH:-
Initiation- speak when spoken to
Reaction d\time-delyed
Rate- slow
Productivity: monosyllabic.
volume-Decreased
Tone- Low pitch
Relevance-fully relevance
Stream-Normal
Coherence: fell y coherent
SAMPLE OF SPEECH:-
N-what do you do in your free line,
P - I listen to music and watch cricket in my free time.
MOOD & AFFEAD:
SUBJECTIVE:
N. Now are you feeding today?
P-I am feel good.
OBJECTIVE-on observation patient looks sad. (mood is incongruent
to affect)
THOUGHT:
Stream of thought:- Normal
form of thought: Normal.
content:- delusion of reference was present
N- do you think anybody dalk about you?
P-yes I think that my friends se do talk about me,
Perception: Normal
Cognitive function:-
Consciousness - councious
orientation:-patient oriented to time, place & person.
Attention-Normal aroused patient able to answer formed &
backword digit.
Concentration: - Normally sustained
memory: immediate, recent and remote memory is intact.
Intelligence
general intelligence is intact
patient is able to sodue written sums
similarities B/w paired object:
N-what is similarity B/w.pen & pencil?
P:- patient say that we can't erase what is written with a pen
bed we can erase what is written with a pencil.
Judgement:-
a) personal:-
N-what you have plan offer getting discharge
P:- He said I will continue my study
B) Scolal- intact
C)Test-Intact
Insight: - grade (3)
Awareness of being sick attributed it to external or physical factor.
Diagnosis formulation:-
Mr. maruti malgade 21 year/male is having Cheif Complain of
Irritable & aggressive Behaviour. Anger. I sed sleep at night conflict
blow family members and also Complaining that my friends use to
talk about me, admitted in male ward on 17/07/2024ssssss and
diagnosis, with "Schizophrenia”.
