Paranoid schizophrenia syndrome, reactive psychosis

# 47

*! Patient A., born in 1988 he entered the hospital complaining of the feeling that someone was controlling him, someone was turning his head, he was saying words through himself, he began to hear the “voices” of the neighbors who directed him, some “voices” protected the patient, and others encouraged, others threatened. He also complained about the feeling that a “Muslim court” had been committed against him. Sometimes I thought that it was a joke and the action of some “narrowly directed waves”, in order to get rid of them, I began to travel around the city to my relatives, but I could not explain anything to them. I didn’t sleep at night, walked up and down the apartment, listened to the “voices”, then I plugged my ears so as not to hear them. In this condition, he was delivered by his parents and hospitalized in a hospital.

What is the syndromic diagnosis?

Hallucinatory-paranoid syndrome (Kandinsky Clerambo syndrome)

# 48

*! Patient A. has previously been treated repeatedly in a psychiatric hospital. On the eve of hospitalization, he lay in bed all day, got up in the evening and froze by the bathroom in one position and stood there for 2 hours. When trying to take away, he offered active resistance to his father. In this condition, he was delivered by his parents and hospitalized in the department. On admission, he sat in the same position, his gaze fixed on one point, his face masked. I did not answer questions.

What is the syndrome?

Catatonic syndrome

# 49

*! Patient K., born in 1990 entered the psychiatric hospital in connection with a change in mental state: he doesn’t sleep at night, walked around the room aimlessly, talked to himself and spoke without substance, sometimes without explaining the reasons, left the house, then made excuses that someone was calling him, that I heard “mental voices” in my head, which reported that the enemies “damaged” him. Under the influence of “voices” he tried to hang himself on a tree, his family was removed from the loop. There was a feeling that they were controlling his thoughts, forbid him to eat, as a result of which he lost a lot of weight.

What is the syndrome?

Hallucinatory-paranoid syndrome (Kandinsky Clerambo syndrome)

#fifty

*! A patient E., born in 1970, was brought to a psychiatric hospital, who claimed that the spirits of famous historical figures Abylay Khan, Kenesary Khan, etc. were instilled into him. ” He colorfully told how he reincarnated in them, at that time his strength and capabilities increased. At the same time, he considered himself “an agent of the KNB with the rank of lieutenant colonel”, stated that he was fulfilling the task of the KNB in ​​this department, that he “would protect Kazakhstan from China. ” In conversation with the doctor, he was arrogant, with a reassessment of his own personality. Paralogous thinking, criticism of his condition is completely absent, believes that after discharge he will be able to work as a lawyer, engage in private business. Background mood remains upbeat.

What is the syndrome?

Paraphrenic syndrome

# 51

*! The guy was 22 years old, 2 months ago, was in a psychiatric hospital with a diagnosis of Schizophrenia. He began to talk a lot and fruitlessly about his "illness." To the question “Do you consider yourself sick,” he answered that “It depends on how you understand the disease. If illness is understood as a form of existence, and to exist is to live, then illness is the same life. The severity of the sensation of life is directly related to suffering. The more suffering, the sharper life. I have no suffering, which means that I am not sick or even live. Hence, my life is formal, at the level of physiological functions, but they are not broken with me.

Which of the following thinking disorders is MOST likely:

Resonance or paralogic thinking?

# 52

*! A 35-year-old woman entered a forensic psychiatric examination in connection with the murder of her partner's ex-wife, whom he had divorced several years ago and which the patient had never seen before. He does not regret his deed. Explains that the killed woman “poisoned” her, “damaged” with poisoned radioactive products, which were transmitted through children who visited her husband. The manner, grimaces, is indifferent to its fate. Reasoning is characterized by verbosity, lose focus. Prone to futile philosophical reasoning.

Which of the following preliminary diagnoses is MOST probable?

Schizophrenia

# 53

*! The girl is 21 years old. Mentally ill since the age of 17, when anxiety arose for no apparent reason, there was a fear of losing one's mind, getting sick with an incurable disease, lowered mood, and thoughts about his inferiority arose. It began to seem that others were looking at him with a mockery, discussing him. He found the reason for this behavior in defects in his appearance. Standing in front of the mirror, "I saw my ugly face, wide nose, narrow eyes." He did not share his experiences with anyone, stopped communicating with friends. He became withdrawn, sullen, emotionally cold, hostile to his parents.

Which of the following preliminary diagnoses is MOST probable?

Sluggish schizophrenia

# 54

*! A 25-year-old girl experiences a painful state of a paroxysmal, devoid of sequence, unsystematic stream of thoughts rushing through her head. At this moment, he is not able to continue his usual work, distracted from the conversation. It is difficult to fully explain his condition. There is a feeling that someone “controls” his thoughts, “makes” them move, then stop.

Which of the following disorders is MOST likely?

Mental automatism

# 55

*! Sick, 13 years old. Father abandoned the family and "disappeared." Childbirth on time, from early childhood is calm, phrasal speech after 3 years, dresses since 7 years. In kindergarten was invisible, mostly played alone. At 6.5 years of age - head injury with signs of concussion. Before school, he himself learned to read, count. There are no friends. He draws well, mainly on military topics, depicts shooting, loss of life, fascist crosses, gallows. He loved to torture animals, killed them, "buried". From the age of 11 he became embittered, did not speak with his mother. Skipped classes at school, wandered or slept. At the age of 13, he stopped going to school, did not communicate with anyone, lay there all day, did not wash, began to eat “dry ration” on his own, did not eat food prepared by his mother. It is difficult to make contact at the time of the inspection, he answers formally, does not communicate with anyone, he only said that he is “step-mother” and the real parents are different.

What is your diagnosis?

Schizophrenia

# 56

*! Patient L., 35 years old. It looks collected and neat, calm in behavior. During the conversation, when it comes to his experiences, he becomes excited, speaks loudly and gestures profusely. Declares that he has been persecuted for a long time and is not allowed to live in peace. He cites numerous "evidence" of his innocence and does not reveal any signs of fatigue during a long conversation. When expressing doubts and trying to clarify something, it is easily irritated and reveals a tendency to rudeness and cynicism. Correction does not lend itself at all. He well remembers all the dates of his personal and public life, especially related to his real experiences. He is going to change his place of residence, make an exchange of an apartment, without considering the opinion of his relatives.

Determine your mental status. Estimated diagnosis.