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Case study 5 psychosis

A 45 year old man was admitted to a


psychiatric hospital because of a psychotic
illness: he had been hallucinating and
believed there was a conspiracy against him.

While in hospital, he began to protest that his


wife of twenty years, who visited him, is not
my wife but a double, adding something has
happened to her: she has been replaced. I
love my wife very much but not that woman
double

What is this condition?

Is it a common condition?

What are the psychiatric disorders


associated?

Case

study 6 - psychosis

A 41 year old single woman who worked as


a secretary in a law firm suddenly
developed amorous feelings for a married,
highly respected solicitor who worked in a
neighbouring firm.

She became convinced that whenever he


passed the window of the office in which
she worked, he sent her private and secret
signals indicating that he was in love with
her.

She knew that he was planning to leave his


wife and children in order to set up home
with her.

Over time she plagued him, sending


sexually explicit letters to his office, and on
one occasion turned up at his home and
confronted him in front of his wife.

What is this condition?

Case

study 7 - psychosis

A 50 year old man developed a belief that


his wife was unfaithful after she had been
out alone with friends on a day trip. He
knew that she had developed a
relationship with a friendly neighbour.

He detected evidence of the liaison in the


form of subtle changes in her demeanour
when she returned from shopping trips.

He went to great lengths to verify her


accounts of her shopping trips, for instance
by checking that the bar codes on the
goods she bought corresponded with the
retail outlets which she claimed she had
visited.

He checked her underwear for evidence of


sexual activity, and would spend hours
questioning and badgering her in order to
obtain a confession.

Case

study 8 - psychosis

Two sisters, Sarah aged 76 Susan aged 72


were both admitted to hospital as they said
that their neighbours were trying to poison
them by pumping gas into their home via
the chimney.

Sarah had been diagnosed with paranoid


schizophrenia many years previously. Susan
had previously been mentally healthy.

Case

study 8- psychosis

A woman aged 43 years was referred to mental


health services after she had first presented to a
dermatologist.

She had complained of an itching sensation under


her skin, which she believed , was caused by small
insects that had invaded her house two years
previously.

She had gone to great lengths to sterilize and


fumigate her house, and she frequently bathed her
skin with antiseptics purchased from a supermarket.

Case study 8 B Psychosis

A 70 year old man presented to the dermatology clinic


with a complaint of itching of his skin and small worms
crawling out of his ears, nose and corners of his eyes.

He carried with him a small bottle into which he had


put some of the worms he had captured coming out of
his body. He became angry when told that the bottle
had just some skin scrapings.

When the doctor referred him to the psychiatric clinic,


he screamed at the doctor that he is not mental and
stormed out of the dermatology clinic

This condition is called delusional parasitosis.

It is difficult to treat but some patients get some


relief with antipsychotics or/and antidepressants.

Most patients will not accept they have a psychiatric


condition and will not take psychiatric medications

The doctor has to be very tactful in handling these


patients and try to help them as they really suffer.