Provide first aid and call an emergency psychiatric care

# 62

*! Citizen K. independently applied to the emergency room of the multidisciplinary hospital with a request to help him and hide from his pursuers. He reported that for about a year he had noticed surveillance. In his absence, listening devices of a special construction were installed in the apartment, capable of not only recording his conversations, but also thoughts. He is anxious, tense, looks suspiciously around. Today, fleeing from his pursuers, he went down the drainpipe from the 4th floor, injured his hands, twisted his leg and came to the hospital by taxi. He cannot explain the motives for the persecution; he believes that "they were mistaken, they mistook me for someone else." Unbelievable, asks to call the police

or the prosecutor.

What psychotropic drugs should be used in the treatment of mental pathology in this patient?

Antipsychotics with antipsychotic effect

# 63

*! Patient T., 32 years old, turned to the local general practitioner with complaints of dyspeptic disorders (rumbling in the abdomen, pain in the stomach, bad taste in the mouth, etc.). The occurrence of these symptoms is associated with the influence of some special rays on him, he believes that doctors who invent "protection against Chernobyl" conduct experiments on this. Sensations first arose about a month ago. At the same time, he began to notice that the people around him were looking at him in a special way, discussing his behavior and actions. He asked in writing to stop the experiments at the Academy of Medical Sciences of Russia, but received no answer. He asks the doctor to "assist in this matter." He claims to feel "rays under the skin, air in the abdomen, moving parts of the intestine", sees some "parasites" in the intestines.

. What treatment methods are indicated for this patient?

Antipsychotic

# 64

The patient is 19 years old. Six months ago, for no apparent reason, anxiety began to grow. He said that he "lost the ability to comprehend", poorly grasping the content of what he read. In all words, he began to "look for a second meaning." Academic performance declined. It seemed that classmates suspect him of something, "they consider him a fool." Lost previous interests. He became indifferent to his studies, did not follow himself, broke off contacts with friends.

What treatment methods are indicated for this patient?

The diagnosis is simple schizophrenia (100%), treatment with antipsychotics

# 65

Patient 30 years old, previously not registered with a psychiatrist. He turned to a neuropsychiatric dispensary at the initiative of relatives. Oddities in behavior appeared six months ago. The patient (a carpenter by profession) became interested in philosophy, parapsychology. He said that he had created a model of a new society, wrote letters to various authorities, and sent drawings of his projects. The conversation is stenichny, affect is not expressive. Willingly talks about his "scientific research." He does not experience deceptions of perceptions. He considers himself mentally healthy, convinced that he made a discovery in social studies.

What drugs are indicated for this patient?

Diagnosis - paranoid schizophrenia (100%), treatment - antipsychotics

# 66

Student of a technical institute, 23 years old. The disease developed for no apparent reason. He became sluggish, lost interest in studying, in communicating with friends, in art and music, which he had "only lived" before. Auditory pseudo-hallucinations, delusions of persecution and hypnotic effects appeared. Declared that his thoughts "read by others." He was almost completely inactive and indifferent, almost constantly expressed ridiculous ideas of various contents. There is no criticism of the state.

What drugs are indicated for this patient?

Kandinsky-Clerambo syndrome, schizophrenia (100%), treatment - antipsychotics

# 67

*! A 45-year-old patient came to a neurologist with complaints of anxiety, restlessness, insomnia, and weakness. In the conversation, it turned out that during the last month she had a flu state, her mood worsened, she could not concentrate on work, she began to hear hail by name,

and then whole phrases. He hears voices as if “inside his head”, believes that someone controls it. He is afraid. notices "disguised pursuers." He believes that they want to kill her, does not go out into the street. She began to notice a suspicious taste of food. She stopped eating, lost a lot of weight, complains of constipation.

What treatment methods are indicated for this patient?

Diagnosis - paranoid schizophrenia (100%), treatment - antipsychotics

# 68

*! A girl, 20 years old, was twice treated in a psychiatric hospital with a diagnosis of Schizophrenia. At home, she behaves defiantly, often comes into conflict with her parents, does not listen to them, leaves home, does not sleep, was seen in the company of young people who drink alcohol, anasha, refused supportive treatment.

What is your alleged treatment?

Antipsychotics

# 69

*! A young man, 22 years old, behaves mannered, foolishly, grimaces in the department of a psychiatric clinic, pretentiousness is noted in movements and speech. Often grimaces, pronounces the words incorrectly, then dances, then somersaults on the bed, laughs out loud at the same time, does not respond to staff comments.

What is your alleged treatment?

Antipsychotics

# 70

*! A patient of a psychiatric hospital, 43 years old, reports that he hears the “voice” of Allah inside his head, which gives him instructions, advice, and conducts a “dialogue” with the patient. According to the mother, at home, the patient claimed that he was being “monitored” by the KGB, pulled out all the switches, and that through the switches the KGB officers exposed him to X-rays - they “eavesdrop” on thoughts and “interfere with thinking.” He closed all the windows tightly, doors, did not leave home, forbade mother to communicate with relatives.

What is your alleged treatment?

Antipsychotics

# 71

*! A woman, 30 years old, registered with a psychiatrist at the dispensary periodically freezes in one pose, often uncomfortable, without changing it for a long time, when she tries to take her away, she resists, but does not answer questions. Once, she suddenly jumped up, quickly ran to the window and struck with her fist, smashed the glass. Sometimes it lies on the bed with its head raised, as if lying on a pillow.

What is your alleged treatment?

Antipsychotics

# 72

*! A man, at the age of 24, began to feel that his appearance was changing, noticed that others were laughing at him, periodically began to hear “voices” inside his head, which said that the food was poisoned, and therefore began to refuse food, he lost a lot of weight. Periodically froze in one pose. He was taken to a psychiatric clinic by his relatives and hospitalized.

What is your alleged treatment?

Antipsychotics

# 73

*! A patient of a psychiatric hospital, 38 years old, upon admission, claimed that he was "possessed by a demon", spoke to himself, in a loud voice, and behaved defiantly. He answered questions, that his actions, actions, thoughts, as well as feelings did not belong to him, periodically growled, made inarticulate sounds. According to the relatives, at home he showed irritation and aggressiveness to his relatives, he could throw his fists at his brothers and sisters, he reacted extremely inadequately to the comments.

What is your alleged treatment?

Antipsychotics

# 74

*! A patient of a psychiatric clinic, 25 years old, was admitted in connection with a change in his mental state when he began to talk to himself, said that he hears “voices” male, female, childish, who ask him for help, the “voice” of Allah, which he gives parting words, began to call himself Allah, said that he had to go to Australia to put out the fire, go to India to save the world, intended to make all people Muslim. Sometimes he froze in one pose, sometimes talking to himself, then cried, then laughed. Parents called an ambulance and he was taken for treatment.

What is your alleged treatment?

Antipsychotics

# 75

*! Patient A., 55 years old, registered with a “psychiatrist” with a diagnosis of Schizophrenia, was taken by the ambulance team to a psychiatric hospital. On admission, the patient boasted of connections with Schwarzenegger, called himself the spirit of Yassaui, declared that he could heal people, and said that he hears the “voice” of Allah, that he acts on his instructions.

Antipsychotics

# 76

*! Patient P., 48 years old. Reappears. A few days before admission to the hospital became closed, secluded. Asked monotonous questions "What's next?" At the same time, he stared at his wife. At night, on the eve of hospitalization, he tried with a fork to injure a sleeping wife. During a conversation with a doctor, he said that "green radio waves are emitted from a neighboring house using a special transmitter." He hears the voices of women, men, children. From the content of the votes, I realized that this is a spy group. The voices speak of the need to kill people, to burn at home. I heard that his wife is a member of this organization. He believes that, by order of the votes, his wife sprinkled poison in his food, in milk. Explains his attack on his wife with a desire to end the "gang of criminals"... What treatment method is most appropriate for the condition

Antipsychotics, correctors

# 77

*! Patient S., 42 years old. Received repeatedly. Mental status at the time of the examination: during a conversation with the doctor, he sits with his hands clasped in his head, and at times looks around. Contact is difficult. Talks about his experiences not very willingly. He complains that it’s hard to control his behavior, as the last 4 days have been “pestering voices”, “voices in the head and throat”. Voices scolded the patient, ordered to chop off his wife’s finger, threatened with reprisal if he disobeyed. Emotionally dull. Outwardly untidy.. Treatment.

Antipsychotics, correctors

# 78

*! Patient L., 18 years old, student. From the anamnesis: about six months ago I stopped attending classes. In the morning I lay down in bed, often just lay with my eyes open. I did not respond to the appeal. Recently, she’s stopped washing, changing clothes. Relatives of the patient invited a folk healer, who determined that the patient was "obsessed with genie", "healed" with Kamcha, prayers. After one of the sessions, the patient attacked him with fists and refused to continue treatment. After this incident, the patient's relatives took her to a mosque, drove her to holy places. The mother of the patient even noted a slight improvement in her daughter's condition. Recently, the patient completely stopped eating, began to harden in one position and could stand for such a long time without changing position, not answering questions. Attempts to feed her were unsuccessful. Relatives of the patient turned to psychiatrists. At admission: does not answer questions. The muscle tone is sharply increased: the patient’s hand, raised by a doctor, hangs in the air for several minutes.

. What treatment method is most appropriate for the condition

The diagnosis is the catatonic form of malignant schizophrenia (100%), the treatment is antipsychotics

# 79

Patient K., 45 years old. Reappears. A few days before admission to the hospital became closed, secluded. Asked monotonous questions "What's next?" At the same time, he stared at his wife. At night, on the eve of hospitalization, he tried with a fork to injure a sleeping wife. During a conversation with a doctor, he said that "green radio waves are emitted from a neighboring house using a special transmitter." He hears the voices of women, men, children. From the content of the votes, I realized that this is a spy group. The voices speak of the need to kill people, to burn at home. I heard that his wife is a member of this organization. He believes that, by order of the votes, his wife sprinkled poison in his food, in milk. Explains his attack on his wife with a desire to end the "gang of criminals."

Your treatment tactics.

Antipsychotics, correctors

# 80

*! Patient A., 45 years old. Received repeatedly. A history of affective-delusional seizures followed by long-term (up to 4-5 years), high-quality remissions. Admission to the hospital is associated with a worsening condition a week before hospitalization. The dream was upset, he became eloquent, all the time he was trying to run somewhere. At the time of examination, psychomotor agitation is noted, easily distracted, without a sense of distance. Discusses on unfamiliar topics with a clear reassessment of one’s own capabilities and abilities. Laughing for no reason, plans for the future are unrealistic. Believes that he knows the thoughts of those around him. Feels the influence of a "laser" that sends "mental information."

Determine your mental status. Estimated diagnosis. Treatment.