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ANAMNESIS Anamnesis is the act of remembering the medical or development history of the patient.

It functions to form a background and measurement of clients functioning and provides understanding of the client’s past, present and potential functioning. It is from the Greek word that derived from Anamimneskein, “Anamne” which means to remind, while “Ana + mimneskein” means to recall. Essential data were all gathered through verbal interaction, hospital records and informants. We started the gathering of data on May 14, 2013 until May 23, 2013 during our CIU and home visits. Considering the ethical conduct of confidentiality, we chose to call our patient as Patient Z. She was born on August 10, 1984, 29 years old, female, confined at SPMCMCPBM Crisis Intervention Unit (CIU) last May 13, 2013 12:05 AM diagnosed with Bipolar I Mood Disorder Mixed Phase with Psychotic Features. INFORMANTS These are the individuals who gave vital information regarding the present and past condition of the patient. It consists of patient’s family, relatives, neighbors and other significant person. The information we gathered from these informants give us a vivid picture of the circumstances surrounding the patient’s condition and further understanding of the psychodynamics of the patient. Informant #1 Name: Mr. Z Age: 48 years old Address: P-2 Manay, Panabo City Relationship to patient: Husband Length of time known to patient: 19 years Understanding Impression to client’s condition: “nasakit lagi ang akong asawa ma’am, nagwild man to siya, tungod kay murag nalisang siya sa pagkakita sa iyang anak nga nikalit rag tumba pagkahuman og inom atong tambal nga para unta sa iyang igsuon.”

Attitude and Characteristics of Informants: Willing to provide information: able to have consistency in narrating events.

tapos wala na dayon ni kaon si patient Z.” Attitude and Characteristics of Informants: Cooperative but sometimes defensive in answering questions about patient’s condition. Informant #4 Name: Mrs. Unta lagi na maayo na siya para makagawas na siya diri. Panabo City Relationship to patient: sister Length of time known to patient: 29 years Understanding Impression to client’s condition: “nabalaka ko ma’am kay tulo na sila kabuok naggawas sulod sa mental. kay bag-o ra baya to nakagawas ang iyang igsuon na laki. unya karon naa si patient Z didto. Naluoy baya ko sa ilang kahimtang kay siyempre igsuon mi. Cotabato Relationship to patient: Mother Length of time known to patient: 29 years Understanding Impression to client’s condition: “murag wala jud nag-alibyo ang iyang sakit.” “nagaway man to sila sa iyang bana.Informant #2 Name: Mrs. A Age: 33 years old Address: P-2 Manay. nitukar napod to ang mga sintomas pareha atong 2008” Attitude and Characteristics of Informants: Cooperative and willing to provide detailed information about patient. Informant #3 Name: Sibling F Age: 32 years old Address: P-2 Manay. Panabo City Relationship to patient: neighbor Length of time known to patient: 4 years . X Age: 52 years old Address: Koronadal.

ang ika-upat niya nga anak naka inom og tambal na para sa iyang igsuon.” . Maong na nervous siya. B Age: 61 years old Address: P-2 Manay. D Age: 20 years old Address: P-2 Manay. Unya pagka-ugma man siguro. Mao na siguro to ang hinungdan. Panabo City Relationship to patient: mother of her brother-in-law/ neighbor Length of time known to patient: 14 years Understanding Impression to client’s condition: “Bughat. Panabo City Relationship to patient: relative/ neighbor Length of time known to patient: 20 years Understanding Impression to client’s condition: “makabantay ko nga murag dili jud normal si ante kay usahay pag mu istorya mi musimang iyang mga tubag. Informant #6 Name: Ms. kana ganing damayon niya ang iyang pagkaon ” Attitude and Characteristics of Informants: Cooperative and responds to questions appropriately Informant #5 Name: Mrs. Mas unahon pa jud niya ang mga buluhaton sa panimalay kaysa sa pagkaon ma’am.Understanding Impression to client’s condition: “usa ka adlaw ato usa ato kay sweldo sa iyang bana. Ang iyang papa pud tung sa Cotabato pa mi. naguol siya kay ang sweldo nahurot rag bayad sa mga utang. pasmo ug kaliwat. Nakabantay pod ko nga mag sige rana siya ug panglaba unya dili mu kaon sa saktong oras. Amua ganing pakan-on kay basin napasmo” Attitude and Characteristics of Informants: Cooperative and willing to give more information. Naa puy usahay kung mag-away na siya sa iyang bana kaydili siya mu kaon. makit-an namo nga mag-estorya estorya siya isa sa kilid. pero murag kaliwat na nila ka y tulo naman na sila na ingun ana.

X. Magsigarilyo pod diay siya ma’am mga isa ka kaha sa usa ka adlaw. we thereby withhold the true identity of Patient Z’s father. Panabo City Relationship to patient: neighbor Length of time known to patient: 12 years Understanding Impression to client’s condition: “okey raman na si Patient Z kato lang jud nahibaw -an nako nga na admit siya sa pangkaduha nga higayon. His educational attainment was only until 5 th grade. X. At this time he still continued to have his vices as verbalized by Mrs.000 pesos/month. he is unemployed due to his age. His monthly salary according to his wife was 1.” When asked for any files that may support the admission of Mr. X from the wife. X claimed that her husband was diagnosed in Cotabato with a mental problem while he was still adolescent. . Iya rapod mga igsuon ang nag ingon sa ako. He had his first job as a farmer at their locality at the age of 18. Nahatagan man daw siya ug tambal sa una. X started drinking liquor and smoking cigarette at an early age. Attitude and Characteristics of Informants: Willing to provide answers to questions. there was no documentation showed. FATHER Mr. as verbalized “nakabalo nalang ko ma’am nga naa diay siya’y sakit nga pareha sakong mga anak katong taod -taod na among kaminyoon ug dagko na among mga bata. Currently.Attitude and Characteristics of Informants: Willing to provide answers to questions. X was born in Panay. tungod man daw to sa iyang anak nga nakainom atong tambal nga para dapat sa iyang igsuon. “muinum paman gihapon siya ma’am pero dili siya mahubog. X and Patient Z’s mother as Mrs. Informant #7 Name: Mrs. Mr. muuli ra siya diretso kung makainon. FAMILY HISTORY: To preserve the principle of confidentiality. After sometime he then worked as a laborer.” Mrs. we shall address him as Mr. E Age: 45 years old Address: P-2 Manay. Antique.

iya dayon mabunalan pero sa uban niya anak close man niya.” She says that her relationship with her husband is not good as verbalized. she worked as a farmer in their locality as verbalized. X described her husband as a good person but with time Mr. They then got married on the year 1979. she verbalized. La Union. Namatikdan nako sa iya ma’am nga karon tuiga maga istorya-storya na siya sa iyang kaugalingon pero murag sa katiguwangon man yata niya na. kung mag disiplina siya iya ra istoryahon ug kasab-an aron mag tanda. In relation to discipling her children. “suod man mi sa akong tatay ma’am makadum-dum gani ko nga iya kong ipababa sa iyang abaga. 4 males and 4 females. X had changed his behavior and personality.Mrs. “ naga hornal man ko sa una ma’am. “dali ra jud na siya saputon ma’am wa nako kasabot sa iya.” . “pag istoryahon nimu si Mr. Sige ra mi ug away. They were blessed with 8 children. When she married Mr. X met Mrs. As for the mother she was only described having behavioral problem as verbalized.” Mr. Cotabato. “dili na jud mi kaayo suod sa akong bana. “ako raman sila ginakasab an usahay mabunalan nako sila. “maayo man siya nga amahan sa iyang mga anak ma’am. X.” Patient Z also added. MATERNAL AND PATERNAL LINEAGES Looking both lineages. naa lang jud isa niya ka anak na permi niya badlungon mao na ang kinamagwangan namu. X ma’am mukalit ra ug lihis iyang tubag. X at their place. As verbalized by Mrs. When she reached 45 years old. X was born in Luna Makilala. Mag gamit ko ug stick nga kahoy pero sahay raman pod nako gamiton kanang dili na jud mutuo. He became moody and at the same he gets mad easily. Such behaviors observed were staring blankly. “suod man siya sa iyang mga anak. and change in approach towards other people. Kung makasala gani to siya. Her educational attainment was until 5th grade only. Mura naman siya gyud ug wala’y pakialam sa amu pamilya niya. talking to his self. X has mental problems. claims from informants supported that Mr.” MOTHER Mrs.” She stated that Mr.” she also added.” She received a salary of 200/ day during that time. X was a good father to his children. The couple then moved to their new residence at Koronadal. X she became a fulltime housewife to her husband and mother to her children.

and was staring blankly. She is the subject for our grand PAR presentation. female and presently resides at Manay. He was then given treatments at the said hospital and was discharge with a diagnosis of Schizophreniform. 3 months akong tiyan atu. Panabo City. single and currently resides at Cotabato together with Mr. X had a miscarriage on her first pregnancy as verbalized. seventh as sibling J and the youngest and eighth child as sibling K. Mrs. He was admitted in SPMC twice.” Sibling I was 23 years old. iya ranang luom luomon ma’am hantod sa ma depress na siya unya din a dayon siya mukaon. does not have any appetite to eat. There were no observable signs for mental problems. male. . D. Panabo City. In relation to her siblings. sixth as sibling I. married with 3 children and living at Manay. “katong iyang kamagwangan nga bae ma’am niadto man to ug abroad dayon gipauli diri kay nagsinto -sinto naman daw didto pero naagapan ra mao wa nilala. there was no evidence of symptoms of mental problems. married and currently living at Manay. Nagdugo naman gyud ko maong gidala naku sa hospital. Panabo City. His second admission was on July 10. According to Mrs. Sibling E. fourth as Patient Z. third as sibling G. single and currently living at Manay. female. His first admission was on the year 2010. Mga 19 man tu akong edad. Sibling H aged 27 years old.” Sibling G was 31 years old. Panabo City together with his older sister. with four females and five males.” First child as sibling E. X their father. He was also seen by his neighbor carrying sharp materials such as knife. male. was talking to himself. married and currently living at P-2 Manay.SIBLINGS Patient Z supposedly has 9 siblings. 2012 where he was diagnosed with Schizophrenia Undifferentiated. mao dapat tu among eldest. fifth as sibling H. Patient Z was 29 years old. female. does not sleep properly. second as sibling F. Patient Z has 2 brothers who were also admitted at SPMC and was diagnosed with Schizophrenia Undifferentiated. He was admitted due to the fact that he was mauling other people and his mother. She stated that “kung naa’y problema si Patient Z. aged 34. female. According to his mother. Sibling E was known to be a drunkard and a heavy smoker. upat ko ka adlaw nag stay didtu. Panabo City. Sibling F was 32 years old. Sibling F went to Singapore and was manifesting symptoms of mental problems as verbalized. Unfortunately. “nakuhaan tuod ko sa una ma’am.

. X also supported her all throughout her pregnancy. X eats healthy foods such as green leafy vegetables. 2013 with the diagnosis of Schizophrenia Undifferentiated.” PERSONALITY HISTORY: PRE-NATAL Patient Z is the 4th child of her parents. male. Mr. Panabo still with his older sister. She also takes in vitamin supplements which she received from the health center. she observed that her younger brother was already acting weird. he accompanied her to the health center twice a month for the first and second trimester and thrice a month for the third trimester. “ma’am murag naa man yata sa among genes ug kanang pag mutung-tung na jud ang edad ug mga 18 musugod na dayon ug tukar plus kanang mapasmohan ma’am. 2013 at SPMC and was discharged May 11. X was happy when she knew that she was pregnant for the 4th time. Mrs. mauled other people as well as their mother. was pacing. According to their older sister. During the admission of Patient Z’s second brother.” Patient Z claimed that they have a good relationship towards each other supported by her mother’s verbalization. As she can recall. Sibling F also added. mag tinabangay man pud sila sa usa’g usa.Sibling J was 21 years old. He was already talking to his self. . Mrs. Mag-away usahay pinaagi sa estorya kanang mag yaw-yaw gyud. She also added that she had received vaccination in a form of TetanusToxoid for the 4th time. she stated that she didn’t experience any complications during the course of pregnancy. single and currently resides at Manay. One of the siblings also claimed that their youngest brother (Sibling K) who was now 17 years old were also projecting weird acts like laughing by himself and talking to his self. fruits and foods that are rich with nutrients. her third brother together with their mother was the watchers and the ones who took care of him. Dili man sila magpinasakitay. He was admitted last May 7. “Okey raman sila ma’am. does not sleeps and eats. Para sa ako mao yata na hinungdan mao nang mmagduha -duha gani ko ug bisita didto kay Patient Z kay ana akong bana nga basin matakdan daw pod ko. at the time her third brother came home after the discharge of brother 2.

” She also claimed that her daughter does not have any allergies to medications.” She also attended to the needs of the newborn. DPT. X said that she cuddles patient Z every time she breastfed her until two years of age.OPV. She was not able to have her secondary education due to financial constraints. Mrs.” .” SCHOOL LIFE Patient Z was seven years old when she entered school. started walking at 2. INFANCY AND CHILDHOOD After giving birth to Patient Z. “ Nagasumbong man siya sa ak o na gina-kusi man siya sa iyang mga classmates. 1984. She had graduated her elementary years with special honors. Gihatagan siya ug Hepa B. X stated that patient Z complained of being bullied as verbalized. Nakatuon ra siya malibang sa CR kay gina kasab-an man nako siya.” as stated by Mrs. food and/or environment. X. okay raman pod siya. Mrs. During Patient Z’s elementary years. BCG. X stated that she delivered patient X through NSVD in their home attended by a “partera/manghihilot”. Iya dayong i-sumbong sa iyang mga teacher. Mrs. “Katong two years old si patient Z.BIRTH After 2 days of labor. Mrs. She started to say “nay/tay” at the age of one year old. ug measles atong 9 months pa siya. Patient Z was born full term on August 10. “nabakunahan mani siya ma’am ngadto sa Cotabato. X after delivery. and had a history of fall from a “duyan” at the same age. She excelled in Filipino subject. X described her child as an obedient student. X “Gisugdan nako siya og pakaon og lugaw na sagolan ra gamay asin atong four months siya. natagak siya gikan sa duyan. “Mo diretso na siya sa gawas unya sa yuta siya malibang uunya ginatabunan ra nako ug yuta.She was toilet trained at the age of three years old as verbalized by her mother. Patient Z was exclusively cared for by her mother. She does her homework every night by herself. Patient Z started to wean at the age of four months as verbalized by Mrs. wala man hinuon na pi-ang. There was no problem experienced by Mrs. she then immediately brought her to the health center for vaccination as verbalized.

Dili man ko magdugay kay kapoy unya daghan pod ug trabahuon. From then on. “daghan naman ko ug natrabaho-an ma’am kanang mangamo jud. E. cough and colds. she applied for a job as a house helper in Panabo City. PLAY LIFE According to patient Z. she prefers to play tumba-lata. she does not save for herself this is to help her parents for their daily needs. bola-bola. kanang maglabad iyang ulo tungod sa ka-init daw to sa iskwelahan. “okey . Mo uli man dayon siya kung tawagan na. PSYCHOSEXUAL LIFE Patient Z had her menarche at the age of fourteen years old. OCCUPATIONAL HISTORY Due to financial problem.” During school meetings. sa duol raman na siya sa among balay magadula-an. X stated that she had observed that her daughter prefers to play with the same sex. She described that her last job was a waitress/helper in a restaurant in Panabo City where she met her husband who was at that time working in a company. She claimed that she only experienced fever. RELIGIOUS AND SOCIAL ADAPTIBILITY Patient Z together with her husband lived at Manay. She verbalized. panagsa ra na siya mo dula kay mo himo mana siya og mga assignments. Panabo City. She was only given medications such as Paracetamol and Carbocisteine. During childhood. She has never experienced any menstrual cramps. Kung ting iskwela. Accorrding to Mrs. Patient Z started to work at an early age. She then had a lot of friends. Mrs. she preferred to have a circle of the same sex. X does not receive any negative remarks about her daughter’s performance. “Kaduha raman siya maka-absent ma’am. “Magsunod sunod raman na siya sa iyang mga kadula kasagaran babae akong makit-an. tago-tagoan and dakop-dakopan. She added by verbalizing. Patient Z stated that she did not experience any major illness or had undergone any surgical procedure.” “Didto sa Cotabato. Mrs. When she was 17 years old.” She received a salary of 600 pesos per month and she shares this to her parents. According to her.Patient Z was punctual in school and only makes absences when she is not feeling well. she had her regular monthly period lasting for 7 days.

She verbalized. Z her husband who was 30 at that time. Wala man nabag-o ma’am bisan pa atong pagkahuman sa iyang pagka hospital atong 2008.” As for their sexual life. “okey raman ma’am. Their house is a 1 storey building made of mixed concrete and wood with 2 bedrooms. The couple resides then at P-2 Manay. Z’s monthly salary is 20. Usahay gani makalimot nana siya ug kaon sa saktong oras kay mag sige ra ug trabaho hanyod nana mu gabii ma’am. The family’s source of income comes from the work of Mr. naa pa’y I ambag namu nga kwarta sa ugangan nako nga bae kay naa man to siya’y Diabetes. lagyo -agyo lang ang mga balay diri-a mao ng kami-kami rasa dang magtapok-tapok. Z who was a laborer of a banana plantation at Panabo City. Mr. Ma satisfy man pod namu ang usa’g-usa. The money that the family gets from Mr. a kitchen. the couple was blessed with five children with four males and one female. bayad sa utang. “dili man kaayo mi maga simbahan ma’am kana rang naa’y time. Panabo City. a living room and a comfort room. suod man pod mi ni Patient Z. naa man to siya’y naka bungol nga silingan namu ug pa rente pod to sa pamilya. Z is just enough to sustain their everyday needs. dili man mi maglalis sa panahon nga kami mag dulog.raman na sila nga pamilya ma’am. Patient Z stated that it is normal for couples to have misunderstanding as claimed.Mr. tabang para pampalit sa tambal sakong mga igsuon.” MARITAL HISTORY Patient Z was 17 years old when she met Mr. para pod sa pag eskwela sa among mga anak unya sa among pang adlaw-adlaw na gastuhonon diri-a sa balay ma’am. Her usual activities start upon waking up and preparing for her daily chores. Her husband proposed to her and asked the parents of Patient Z’s approval for their marriage. Katong bag-o ra ma’am.” During interview. It was on the year 2002 when the couple married. With their 11 years of marriage. Mabalaka lang si Patient Z basin daw kapuyon ko nga aduna pa raba ko’y trabaho inig ka ugma. “sayo pa lang sa buntag ma’am magsugod na siya ug trabaho maglaba ba kaha o maghinlo sa balay.000 pesos approximately. “wala man mi naga family planning ma’am .” He also added. According to one of the informants. “mag-away panagsa ma’am tungod anang kwarta. X described their relationship as.” Patient Z was Roman Catholic by faith until she was married.

Her husband became very worried about his wife’s state and on the same month. tried to remove her IVF on her arm and she was uncontrollable. No remedy worked.kato rang last mi nga nag dulog kay nag gamit nako ato ug medyas kay daghan naman jud amung anak. he went back home to Manay. At home. She did not like to eat. hoping that she would eat and her appetite would increase. she bought and drank juice for herself later that day. Mrs. The husband claimed that he brought his wife to SPMC December 30. Three days later. Z narrated that on September 10. 5 naman jud sila ma’am. one of the co-workers of Patient Z’s husband suggested to bring his wife in SPMC and try to receive treatments for it might be a good try. After which he said that Patient Z got better and was discharged after 4 hours. her husband bringing groceries and presents went to visit her wife and was surprised to see his wife to be so thin and seemed like she has not eaten in years. After witnessing his wife’s condition.” PAST MEDICAL HISTORY: Mr. she was brought to the hospital by her family because according to Mr. Z she was experiencing tetanus-like symptoms “nanggahi ang jaw. While she was waiting at the gate of the school. after she was brought from the hospital. 2008.) . September 13. She was discharged from the hospital after 10 days. Z claimed that her wife seemed like she had “powers” since she broke glasses. She lived there for three months and on December 24. Her husband cooked the family’s meals.” In the hospital Mr. Patient Z was in a hurry to pick up her son in school and was not able to eat breakfast. (There were no records found both on the archives as well as the OPD files with regards to the 2008 admission of Patients Z. X decided to bring her daughter (Patient Z) to their hometown and took the responsibility of taking care of her. her husband had observed that she was starving herself and shipped meals. 2008 morning. her husband observed her to be unusual. kept staring blankly and seemed like she had deep thoughts. 2012. 2012 5:00 PM and was given medications. Panabo depressed with what he just saw.

After seeing the incident. Patient Z managed to live a normal and healthy life with her family for almost 5 years.. Sige ra sad mi ug away kay tungod sa kwarta. Dili dayon mutuo kung suguon. Unya ingon pod akong kinamagwangan nga grabe daw mamunal ilang mama sa iya tungod kay gahian man pod sila ug ulo. PR. there was a change in her personality as verbalized by Mr.After discharge. X. I tab BID (6pm) o Chlorpromazine 200 mg 1 tab. On a saturday night May 11.98 bpm.2013 . Patient Z’s mother prepared a glass of milk mixed with a pulverized anti psychotic medication for her newly discharged brother which he refused to drink and left it on the dining table. The patient was seen and examined by Dr. She then panicked hysterically. BP110/80 mmHg. 1 tab at HS (9 pm) o Haloperidol 5 mg amp (12:30 pm) 1 amp IM now . Patient Z witnessed that her son fell into the floor and lost consciousness.2° C. She started pacing. CBC and pregnancy test Medications: o Buscopan 1 amp IVTT now q 8 PRN for abdominal pain o Ranitidine 1 amp IVTT now o Omiprazole 40 grams 1 cap 30 min before breakfast o Risperidone 2 Grams ½ tab 2x a day o CPZ 200 mg 1 tab   ½ tab in AM (6am) 1 tab BID (9pm) o Lithium CO3 450 mg 1 tab (6am). Then she was admitted at SPMC-MCPBM May 13. RR-24 cpm. Ismael Cordero Jr. talking to herself. “dali na s iya masuko ma’am. and was given the following orders: Please admit For UA. patient Z’s 4 year old child mistakenly took the glass of milk and drank it. According to Mr. ½ tab in AM (6 am). Unfortunately. Her vital signs during that time were as follows: Temp. Z during the time her wife returned to her normal life.36.” ONSET OF PRESENT ILLNESS: For almost a week already. crying and aimlessly walking around the house. she started to act differently. 2013 12:05 am with an admitting impression of Bipolar I I Mood Disorder Mixed Phase with Psychotic Features. Panabo City. Patient Z’s 2 brothers and mother had their vacation at their home in Manay.

. The patient stayed at the CIU for 8 days and was discharge on May 21. 2013 with the final diagnosis of Bipolar I Mood Disorder Mixed Phase with Psychotic Features.o Bepiridine HCl 2 mg/ tab (6 am). 1 tab PRN for EPS (6am).