Psychology Case Profile

Schizophrenia
Submitted by: Shivapriya Sivadas
Class and Div: 12 Sci E
Gr No: 35531
Academic year: 2022-23
The Indian High School
Dubai

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 The Indian High School

Bonafide Certificate
This is to certify that Shivapriya Sivadas of class 12 Sci E has
successfully completed her Case Profile on the topic of
Schizophrenia as guided by Ms. Liza Varghese during the
academic year 2022-2023.

Teacher in charge:
________________

Internal Examiner: External Examiner:

____________________ ___________________

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 Acknowledgment

I would like to express my gratitude to my psychology teacher Mrs.

Liza Varghese under whose guidance and support I was able to
successfully carry on with this case profile.
I would also like to acknowledge and thank all the sources I visited for
research and have collected information from to complete this case
profile.
I would like to thank my family for their support and encouragement as
I worked on the case profile. I appreciate the cooperation shown by
everyone toward the completion of my case profile.

Name: Shivapriya Sivadas

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 Table of Contents

S No Topic Page number

1 Introduction 5

2 Symptoms of Schizophrenia 7

3 Causes of Schizophrenia 13

4 Effects of Schizophrenia 16

5 Diagnosis and Intervention 17

6 The stigma against Schizophrenia 22

7 Demographic data 25

8 Case history 26

9 Therapy and Medication 28

10 Conclusion 29

11 Bibliography 30

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 Introduction

Schizophrenia is a serious mental illness characterized by incoherent

or illogical thoughts, bizarre behavior and speech, and delusions or
hallucinations. It involves chronic or recurrent psychosis.

It affects the way a person thinks, acts, expresses emotions, perceives

reality, and relates to others. Though schizophrenia isn’t as common as
other major mental illnesses, it can be the most chronic and disabling.
People with schizophrenia often have problems doing well in society,
work, school, and relationships. They might feel frightened and
withdrawn and appear to have lost touch with reality.

It is among the most disabling and economically catastrophic medical

disorders, ranked by the World Health Organization as one of the top
10 illnesses contributing to the global burden of disease. Although
exact estimates are difficult to obtain, schizophrenia affects less
than 1 percent of the population. This lifelong disease can’t be cured
but can be controlled with proper treatment.

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 Symptoms of Schizophrenia

Symptoms of schizophrenia are classified into two types:

1. Positive symptoms:
Here the word "positive" means the presence rather than the
absence of symptoms. They can include:

 Hallucinations:
These usually involve seeing or hearing things that don't exist.
Yet a person with schizophrenia has the full force and impact of
a normal experience. The types of hallucinations in schizophrenia
include:

- Auditory:
The person most often hears voices in their head. They might
be angry or urgent and demand that they do things. It can
sound like one voice or many. They might whisper, murmur, or
be angry and demanding.

- Visual:
Someone might see lights, objects, people, or patterns. Often
it’s loved ones or friends who are no longer alive. They may
also have trouble with depth perception and distance.

- Olfactory and gustatory:

This can include good and bad smells and tastes. Someone
might believe they’re being poisoned and refuse to eat.

- Tactile:
This creates a feeling of things moving on your body, like
hands or insects.

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 Delusions:
These are false beliefs that are not based on reality. Types of
delusions include:

- Persecutory delusions:
The feeling someone is after you or that you’re being stalked,
hunted, framed, or tricked.

- Referential delusions:
When a person believes that public forms of communication,
like song lyrics or a gesture from a TV host, are a special
message just for them.

- Somatic delusions:
These center on the body. The person thinks they have a
terrible illness or bizarre health problem like worms under the
skin or damage from cosmic rays.

- Erotomanic delusions:
A person might be convinced a celebrity is in love with them or
that their partner is cheating. Or they might think people they’re
not attracted to are pursuing them.

- Religious delusions:
Someone might think they have a special relationship with a
deity or that they’re possessed by a demon.

- Grandiose delusions:
They consider themselves a major figure on the world stage,
like an entertainer or a politician.

 Disorganized thinking:

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 Disorganized thinking is inferred from disorganized speech.
Effective communication can be impaired, and answers to
questions may be partially or completely unrelated. Rarely,
speech may include putting together meaningless words that
can't be understood, sometimes known as word salad.

 Abnormal motor behavior:

This may show in several ways, from childlike silliness to
unpredictable agitation. Behavior isn't focused on a goal, so it's
hard to do tasks. Behavior can include resistance to
instructions, inappropriate or bizarre posture, a complete lack of
response, or useless and excessive movement.

2. Negative symptoms:
Negative symptoms refer to an absence or lack of normal mental
function involving thinking, behavior, and perception. You might
notice:

 Lack of pleasure:
The person may not seem to enjoy anything anymore. A doctor
will call this anhedonia.

 Trouble with speech:

They might not talk much or show any feelings. Doctors call this
alogia.

 Flattening:
The person with schizophrenia might seem like they have a
terrible case of the blahs. When they talk, their voice can sound
flat, like they have no emotions. They may not smile normally or
show usual facial emotions in response to conversations or things

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 happening around them. A doctor might call this affective
flattening.

 Withdrawal:
This might include no longer making plans with friends or
becoming a hermit. Talking to the person can feel like
pulling teeth: If you want an answer, you have to work to pry it out
of them. Doctors call this apathy.

 Struggling with the basics of daily life:

They may stop bathing or taking care of themselves.

 No follow-through:
People with schizophrenia have trouble staying on schedule or
finishing what they start. Sometimes they can't get started at all. A
doctor might call this avolition.

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 Causes of Schizophrenia

The exact causes of schizophrenia are unknown. Research suggests

a combination of physical, genetic, psychological, and environmental
factors can make a person more likely to develop the condition.

Problems with certain naturally occurring brain chemicals, including

neurotransmitters called dopamine and glutamate, may contribute to
schizophrenia. Neuroimaging studies show differences in the brain
structure and central nervous system of people with schizophrenia.
While researchers aren't certain about the significance of these
changes, they indicate that schizophrenia is a brain disease.

Risk factors include:

 Genetics: Schizophrenia tends to run in families, but no single

gene is thought to be responsible. It's more likely that different
combinations of genes make people more vulnerable to the
condition. However, having these genes does not necessarily
mean you'll develop schizophrenia.

 Pregnancy and birth complications: Research has shown

people who develop schizophrenia are more likely to have
experienced complications before and during their birth, such as
low birth weight, premature labor, and a lack of oxygen during
birth. It may be that these things have a subtle effect on brain
development.

 Drug abuse: Drugs do not directly cause schizophrenia, but

studies have shown drug misuse increases the risk of
developing schizophrenia or a similar illness. Certain drugs,
particularly cannabis, cocaine, LSD, or amphetamines, may
trigger symptoms of schizophrenia in susceptible people. Using
amphetamines or cocaine can lead to psychosis, and can cause

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 a relapse in people recovering from an earlier episode.
Research has shown that teenagers and young adults who use
cannabis regularly are more likely to develop schizophrenia in
later adulthood.

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 Effects of Schizophrenia

Without treatment, schizophrenia will lead to unfortunate results.

Because of the severity of this disorder, untreated schizophrenia may
lead to some of the following effects:

 Anxiety and overwhelming fear

 Inability to maintain a job or obtain work
 Substance use and addiction
 Homelessness
 Dangerous or self-harming behaviors
 Suicide attempts or thoughts of suicide
 Financial difficulties or inability to manage finances
 Isolation from others
 Neglect of medical or dental care
 Neglect of family or pets
 Relationship conflict and difficulty in relationships
 Paranoia that consumes daily living

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 Diagnosis and Intervention

According to the DSM-5, a schizophrenia diagnosis requires the

following:

 At least two of five main symptoms: Those symptoms,

explained above, are delusions, hallucinations, disorganized or
incoherent speech, abnormal or unusual movements, and
negative symptoms.
 Duration of symptoms and effects: The key symptoms you
have must last for at least one month. The condition’s effects,
whether or not they meet the full criteria for the symptoms must
also last for at least six months.
 Social or occupational dysfunction: This means the condition
disrupts either your ability to work or your relationships.

There aren’t any diagnostic tests for schizophrenia-spectrum

conditions. But healthcare providers will likely run tests to rule out
other conditions before diagnosing schizophrenia. The most likely
types of tests include:

 Imaging tests: Healthcare providers will often use computerized

tomography, magnetic resonance imaging, and other imaging
tests to rule out problems like stroke, brain injuries, tumors, and
other changes to your brain structure.
 Blood, urine, and cerebrospinal fluid tests: These tests look
for chemical changes in bodily fluids that might explain changes
in your behavior. They can rule out heavy metal toxicity or other
causes of poisoning, infections, and more.
 Brain activity testing: An electroencephalogram detects and
records the electrical activity in your brain. This test can help rule
out conditions like epilepsy.

Treating schizophrenia and related conditions typically involves

multiple methods. Those methods can happen in combinations or
steps.
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1. Medications:

There are two main types of medications that treat schizophrenia.

 Typical antipsychotics: These are also called first-generation

antipsychotics. They block how your brain uses dopamine, a
chemical your brain uses for cell-to-cell communication.
 Atypical antipsychotics: These medications, also called
second-generation antipsychotics, work differently from first-
generation antipsychotics. These block both dopamine and
serotonin, two key communication chemicals in your brain.
Clozapine is a particularly effective medication that can treat
symptoms of schizophrenia when other drugs don’t work.
However, it has a rare serious side effect that requires frequent
blood monitoring to keep people safe, which is why healthcare
providers usually recommend other antipsychotics first.

2. Psychotherapy

Psychotherapy methods like cognitive behavioral therapy can help

people with schizophrenia cope with and manage their condition.
Long-term therapy can also help with secondary problems alongside
schizophrenia, such as anxiety, depression, or substance use issues.

Another key way therapy helps is with treatment adherence. As

mentioned above, people with schizophrenia often don’t understand or
recognize their symptoms, so they feel like they don’t need treatment.
People with schizophrenia who continue therapy are more likely to
follow treatment plans and guidance from their healthcare providers.

Other therapy methods that might help include art therapy and drama
therapy, which can aid with loss of motivation and a person’s ability to
recognize their symptoms. Healthcare providers might also
recommend techniques that focus on helping with social skills, setting
up self-care routines, and more.

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3. Electroconvulsive therapy

In cases where a person’s schizophrenia doesn’t improve after trying

certain medications, and the person is at-risk for self-harm or harming
others, healthcare providers might recommend
adding electroconvulsive therapy. This treatment can bring rapid
improvements when medication alone will take too long to have an
effect.

However, ECT use isn’t common because it carries a heavy stigma

and because TV, movie, and other media are rarely accurate in
showing how this treatment happens.

This treatment involves using an electrical current applied to your

scalp, stimulating certain parts of your brain. That stimulation causes a
brief seizure, which can help improve brain function for people with
severe depression, agitation, and other problems. People who receive
ECT receive anesthesia, so they’re asleep when this procedure
happens and it isn’t painful.

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 The stigma against Schizophrenia

Schizophrenia is one of the most complicated and destabilizing mental

disorders. At the same time, it can be highly treatable and it’s possible to
make a meaningful recovery.
However, deep stigma against schizophrenia and mental illness, in
general, persists around the world. That prejudice can be as obvious as
calling someone “crazy” or “insane.” Or it can be more subtle, such as
discrimination against job applicants who have schizophrenia. Stigma in
any form can be harmful. The stereotypes about schizophrenia can
create real barriers, such as social isolation, low self-esteem, trouble
finding employment, a hard time forming or keeping close relationships,
and delays in seeking help. Sometimes the stigma can become
dangerous and lead to bullying, harassment, or physical violence. It
also can worsen your mental illness.
One of the best ways to fight prejudice is to challenge it. It can be as
simple as sharing the story of your schizophrenia with others or getting
to know someone with mental illness and learning about their condition.
Compassion, honesty, care with language, and self-empowerment are
all powerful tools to push back against stigma.

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Case Profile

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 Demographic Data

 Name: Anonymous
 Age: 25
 Gender: Male
 Nationality: Indian
 Social class: Middle socio-economic class
 Caste: Kuppuswamy’s Upper- middle, Grade II
 Family: Mother, Father, and 2 younger siblings

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 Case history

A history of head injury was reported when the patient was 10 years
old. A metal rod pierced his forebrain. The parents reported that their
children's psycho-social functioning was deteriorating. Since
childhood, the patient's parents and a close relative have reported that
he has been reserved and shy, rarely initiating conversation or any
activity and hesitant to talk to others. Members of the family noticed
behavioral changes in the teenager during the early stages of his
adolescence, but they tended to view them as just part of growing up
and didn't take them seriously. His ongoing irritability and anti-social
behavior became worse over time, and culminated in a violent
outburst with a neighbor over a minor financial issue.

There was no evidence of any prior history of complex trauma, alcohol

or drug use, physical or psychiatric illness on the mother's part during
pregnancy. He attended formal schooling from the age of four until he
graduated from secondary school at the age of nineteen. There were
no reports of difficulties learning. The patient discontinued his studies
in accordance with parental guidance. He was not very active in
groups and had a less-than-healthy relationship with his younger
siblings. His activities were mostly sedentary.

The mental status examination showed that the patient's eye contact
was intermittent and he moved his eyes suspiciously and furtively. The
amount of speech decreased and the patient became reluctant to
express some of his views and beliefs. During the conversation, there
were periods of silence and digressions, with changing tones of voice.
His attention and concentration were preserved to some extent. The
participant's reaction time was normal and there were no signs of
compulsive behavior or habits. The individual's orientation to time,
place, and person remained intact. The patient's insight into the illness
was very limited. He completely attributed the illness to others around
him.

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The patient reported symptoms of restlessness and irritability at the
time of admission, and an incident of a violent attack on his mother
just before arriving at the health care center. The patient exhibited
suspicious behavior, delusions of reference and persecution during his
admission and stay in the health care center. It was learned that, in
the prodromal phase, he presents nonspecific symptoms, like loss of
interest, irritability, oversensitivity, lack of appetite, and insomnia.

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 Therapy and Medication

The investigation included a general physical examination and routine

investigations, as well as the formulation of a case history in the health
care centers where he was admitted or visited since his diagnosis.
There were no positive results on CT scans and EEG records. The
client first consulted with a psychiatrist in April 2006, after
experiencing his first violent episode. The client was prescribed
regular medication after the disorder was diagnosed to help alleviate
the symptoms. Some of the prescribed drugs were: Olanzapine,
Divalproex sodium, Spain plus Trifluoperazine, Trihexyphenidyl,
Aripiprezole and Trihexyphenidyl hydrochloride. He was given drug
therapy and instructional therapy as part of his treatment. Parents and
a caregiver were educated about the disorder of the client, which has
potential for many forms of mental health problems.
Psycho-education is a more holistic and competence-based approach
to health and wellness. It emphasizes on coping and empowerment,
which helps people to become more independent and capable of
managing their own health. The client and caregivers were made
aware of this disorder early on, in order to better understand and
support the person with the disorder. After establishing a strong
emotional connection with the client, cognitive-behavioral therapy was
administered in one of the sessions. The client was discharged from
the health care center after 23 days, and did not continue with the
sessions planned in the beginning. A healthy therapeutic alliance
could not be formed with the client and any caregivers. The socio-
economic status of the family, and their lack of time and focus on the
problems of the client, were major obstacles in this case.

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 Conclusion

Schizophrenia is a severe, chronic psychiatric illness characterized by

delusions and hallucinations, negative symptoms, and cognitive
dysfunction that frequently leads to a lifetime of impairment and
disability. The average age of onset for many psychotic disorders is
during the most crucial period of educational, occupational and social
development. Schizophrenia does not have a cure. However,
treatment through a combination of medicine and therapy tailored to
each individual can help control many of the symptoms. Day-to-day
support and treatment can help reduce the impact the condition
has on daily life.

In the given case, the progression of the disease was gradual and
reached its peak in the critical period of life, while the client was in his
adolescent years and facing significant stress due to academics.
People with persistent psychotic disorders need ongoing treatment in
a safe and stable environment that is conducive to their recovery. The
client has a supportive and healthy living environment. There is no
specific severe stress in the patient's childhood that could be directly
responsible for their symptoms, other than the forebrain injury and
complaints of not sending the patient to a more established school.
Short-term instructional therapy and psycho-education were used to
manage the symptoms of the client. Parents were advised to make the
home environment as comfortable as possible for their child. The
stress on the parents and their family, their socio-economic status,
and their lack of knowledge about the disorder can be a major factor in
the disorder's development.

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 Bibliography

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Study_of_a_Young_Patient_with_Paranoid_Schizophrenia
by Vipasha Kashyap, January 2015

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