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Case Study
(Undifferentiated
Schizophrenia)
Pressented By:
Eilasor B. Roldan
BN801
I. OBJECTIVES
General Objectives
Specific Objectives:
1. Talk about the personal, social and familial history of the client
3. Define schizophrenia
Specific Objectives:
• Re-orient self as to the proper time, date and place of the events
II. INTRODUCTION
Out of all the patients who have been diagnosed with having
schizophrenia, I chose Sir. N.A.C. because I handled him personally for
almost two weeks. I get interested in his behavior towards others and
want to know the reason behind his being admitted to the institution.
According to his chart, he had been mentally ill since 1977 and
was consulting a psychiatrist; his last check up was on June 1994 at
Western Visayas Medical Center, Mental Health Unit, Pototan Ilo-Ilo; he
lost to follow up for consultations. Six weeks prior to admission, he
again burned important documents such as insurance documents,
transcript of records and became destructive. He also stated that he
heared some voices that says “Sunugin mo ang mga pera at mga
papeles mo para wala nang makinabang na iba”.
• Speech
• Emotional State
Thought Process
• Nutritional-metabolic pattern
• Elimination pattern
• Self-perception pattern
Client's main concern is his sister that is not visiting him for 1 year
and 4 months now. He is worried about her and also the bills of his
hospitalization.
• Role relationship
• Sexuality-reproductive pattern
V. SYMPTOMS
- the patient
verbaliezed that he
got depressed when
he flanked the board
exam
* Suspiciousness Not manifested Suspicion is lack of trust. This
could be due to anxiety, over
stress. This is also due to a
lesion of the amygdale region,
which also manifest
fearfulness.
Onset: It is stated by the client that after his failure to the board
exam he got depressed and had auditory hallucination of “sunugin mo
ang pera at papeles mo para walang makinabang na iba” since 1977.
since then he had been committed to a psychiatrist and having a
routine check up on Western Visayas Medical Center, Mental Health
Unit but on June 1994 he failed to have his routine checkup and never
had a follow up since then. On 1995 he started to be aggressive and
again burned piece of money and papers. He even attempted to burn
their house. He is non compliant with his medications and became
destructive. His eldest sister and neighbors filled a case against him
because they are afraid to be hurt by him. He then been jailed and
after 6 months of being jailed his father requested the court to transfer
the client to a mental hospital. On December 15, 1995 the Municipal
Court of Pototan ordered a transfer to National Center for Mental
health. The client was then admitted to pavilion 4, then the clent
shows signs of regression he then been transferred to pavilion 11 and
when he recovered the client had been transferred to a rehabilitation
ward pavilion 21.
VII. EPIDEMIOLOGY
Schizophrenia occurs equally in males and females, although
typically appears earlier in men the peak ages of onset are 20–28
years for males and 26–32 years for females. Onset in childhood is
much rarer, as is onset in middle or old age. The lifetime prevalence of
schizophrenia the proportion of individuals expected to experience the
disease at any time in their lives is commonly given at 1%. However, a
2002 systematic review of many studies found a lifetime prevalence of
0.55%. Despite the received wisdom that schizophrenia occurs at
similar rates worldwide, its prevalence varies across the world, within
countries, and at the local and neighborhood level. One particularly
stable and replicable finding has been the association between living in
an urban environment and schizophrenia diagnosis, even after factors
such as drug use, ethnic group and size of social group has been
controlled for. Schizophrenia is known to be a major cause of disability.
In a 1999 study of 14 countries, active psychosis was ranked the third-
most-disabling condition after quadriplegia and dementia and ahead of
paraplegia and blindness.
VIII. ETIOLOGY
Childhood
Client was raise by his grandparents, but as he grows up,
his grandparents died reason for him to stay with his
parents. He stated that he is not close with his siblings
because he is the only guy and did not grow up with them
reason why preferred to stay at his room and be alone all
the time.
Adolescence
Client was a loner and got no friends. During this stage he
learned to drink and smoke.
Use of Drugs
There was no abuse of drugs in the family.
Genogram
Mersidita
Nonilito
(mother)
(father)
Noel Delrita
Doronita
Undifferentiated (sister)
(sister)
Schizophrenia
PHYSICAL DEVELOPMENT
The young adult has completed physical growth by the age of 20.
They are usually quite active, experience severe illnesses less
commonly than older age groups, tend to ignore physical symptoms,
and often postpone seeking health care. This stage has its physical
markings, but they come about slowly, almost sneakily. Body hair may
increase; scalp hair may decrease. But more importantly, there are
internal changes that can have critical effects. As the body becomes
more “efficient”(not needing to produce extra hormones, cells and
energy for growth), there is a natural concurrent lowering of appetite.
If this is not respected, the body will be given more food than it needs,
and overweight and sluggishness will ensue. Similarly, with the
increased efficiency, the individual has (potentially) more stamina than
ever, and this can be maintained all through this stage. This is a “talk”
period of life, active and achieving, but there needs to be care that the
talk is matched with enough muscle involvement and emotional
equilibrium to stay healthy. What applies to young people also applies
to adults. They can abuse their sense of self-responsibility and load up
on whatever they please, or they can let the creative process work
here as well, guiding them to a sense of fitness of quantity and quality.
As mentioned above, a heightened sensitivity is needed, for the
metabolism is changing actually becoming more efficient and food
intake should be adjusted accordingly.
During this stage, rules and laws are valued because they maintain
social order worth preserving. Morality is guided by higher principles of
human conduct. Individuals appreciate the social purposes served by
laws. They believe laws should be derived from a democratic
consensus. Individuals search their own conscience for universal
ethical principles. They do not make up their own rules but instead
arrive at abstract principles that all religions or moral authorities might
view as compelling or fair. There is a correlation between higher stages
of reasoning and higher levels of moral behavior.
Disease Process
Psychopathology
IX. TREATMENT
Psychosocial treatment