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Thread: case help needed

  1. #1
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    Default case help needed

    Please can you tell me what is diagnosis of the following 3 cases. thanks

    1. Mr PD lives with his 70 year old wife, who is disabled by arthritis and is very
    dependent upon him. Over the last few years he has found it increasingly difficult
    to manage. Previously fit and active, now he feels stiffer and seems to take longer
    to do everything. He also has noticed his hands trembling but is not worried
    because it goes away when he starts moving.
    He puts all this down to a combination of age and the same arthritis as his wife. He
    assumes that would also account for his slightly bent spine and shuffling when he
    walks. He is worried about becoming senile and not being able to look after his wife.
    All this is also making him feel very miserable.

    2. The patient is Mrs ED, aged 49 yrs, who works as a hairdresser. Mrs ED has
    become increasingly quiet and miserable over the past 8 months. She has been
    arriving late for work and although normally a very talkative person she has become
    less communicative and friendly with clients. She no longer goes out with friends
    or visits her children, and her husband is very concerned about how distant she has
    become. She admits to being ‘a bit worried’ but thinks this is natural at her age and
    can’t see things getting any better. She seems to go to sleep easily enough but
    finds she wakes early in the morning and just lies awake worrying. She also gets a
    lot of heartburn and occasional diarrhoea.

    3. Ms PS has had to drop out of her 2nd year University biology course.
    She started missing classes and getting very poor marks, and
    eventually had what friends called a “nervous breakdown” just before
    exams. She was admitted involuntarily to a psychiatric hospital under a
    section of the Mental Health Act after becoming increasingly disturbed.
    She claimed initially that other students were plotting against her to
    prevent her attending, then said the University authorities were planning
    to fail her. Later she complained the United Nations had decided to
    imprison her because she had discovered that biology was the key to
    meaning of the Universe. She claimed to hear them discussing her
    case via a mobile phone implanted in her skull.
    Her mother described PS as a solitary child, especially since the time
    she had separated from PS’s alcoholic father when PS was 13.

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    Read on the following disorders

    1. Parkinson's
    2. major depressive disorder
    3. schizophrenia

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    Quote Originally Posted by drchinx View Post
    Read on the following disorders

    1. Parkinson's
    2. major depressive disorder
    3. schizophrenia
    Thanks neuro doc...I got 2 right out of 3

    Why is the last one not "vocal hallucinations" ???

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    not sure what you mean about vocal hallucinations amal...

    I usually refer to kaplan and saddock's synopsis of psychiatry for reference. There's a criteria that has to be met for the diagnosis of schiz. The third case presented with paranoid delusions and auditory hallucinations which probably led to disturbed behavior. This would suggest schizophrenia, paranoid type. There's also an allusion to her premorbid personality suggestive of maybe a schizoid personality or maybe depression. The duration of symptoms isn't very clear. So you might want to include schizophreniform disorder or brief psychotic disorder in the differential diagnosis.

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    thanks guys

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    Quote Originally Posted by drchinx View Post
    not sure what you mean about vocal hallucinations amal...

    I usually refer to kaplan and saddock's synopsis of psychiatry for reference. There's a criteria that has to be met for the diagnosis of schiz. The third case presented with paranoid delusions and auditory hallucinations which probably led to disturbed behavior. This would suggest schizophrenia, paranoid type. There's also an allusion to her premorbid personality suggestive of maybe a schizoid personality or maybe depression. The duration of symptoms isn't very clear. So you might want to include schizophreniform disorder or brief psychotic disorder in the differential diagnosis.
    Ok boss !!! I'll take note of this. I haven't read psychiatry yet. Thanks for the info.

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