Name of Patient: Karthik

Patient Case: Schizophrenia

Schizophrenia is a chronic, severe mental disorder that affects the way a person thinks, acts, expresses
emotions, perceives reality, and relates to others.  Schizophrenia may result in delusion and
hallucinations. Patient Karthik is diagnosed with chronic schizophrenia. On his first day of visit karthik
has few symptoms- he expresses delusions in which he is being paranoid and have ideas of reference.

PERCEPTION
 He has also auditory hallucination because he does complain of a noisy neighbor, who he “hears
at all hours of the night.”
AFFECT AND MOOD
 He display a bit of a flat affect
APPEARANCE , BEHAVIOUR AND COOPERATION
 His eye contact is abnormal because his blinking is reduced in frequency, making his gaze seem
like he is staring. 
 He also experience bradykinesia in which his facial movement is minimal
 And have mannerism where in he twirls his hair occasionally.
nd
2 VISIT
DELUSIONS
 He expresses paranoid delusions because he thought that his neighbour is following him
 Ideas of reference because he thought that his neighbour is spreading humors about him.
PERCEPTIONS
 He has auditory and visual hallucinations because he is seeing his neighbour at the store and
hearing it through his walls.
SPEECH
 He has a general delayed/slowed speech
 Karthik also has a prolonged latency to response, decreased prosody
SPEED
 He complains of racing thoughts and an inability to concentrate.
APPEARANCE, BEHAVIOR AND COOPERATION
 He is disheveled (messy hair and dirty shirt)
 He is displaying minimal eye contact
  and psychomotor retardation (his movements are slower than the first visit).
rd
3 VISIT
DELUSIONS
 His delusions of paranoia and delusions of reference strengthen (he is now fully convinced that
his neighbor wants to kill him
PERCEPTION
 His auditory hallucination become more frequent and disturbing
SPEECH
 His speech is slowed and has a prolonged latency to response, decreased prosody
COHERENCE
  he displays loose associations and tangential speech, as well as at least one neologism
SUICIDALITY
 He begins to develop suicidal ideation, hearing voices telling him to kill himself.
OBESSIONS
  he endorses fear that his neighbor is trying to poison his water supply (by accessing the water
pipes in the utility room of the building).
APPEARANCE, BEHAVIOR AND COOPERATION
 He arrives disheveled, with messy hair and dirty clothing
 His eye contact is abnormal because he is looking around the room
 He displays bradykinesia (slowness of movements; latency to respond to questions)
 as well as akathisia (involuntary movements, restlessness, discomfort in his chair

Name of Case:  Robbin

Diagnosis: Bipolar Disorder

Bipolar disorder is a brain disorder that causes changes in a person's mood, energy, and ability to
function.

1st day of visit

AFFECT AND MOOD

 Robbin displays a constricted/flat affect and anhedonia

SPEECH

 Her speech is slowed/delayed and rarely respond to therapist questions

APPEARANCE, BEHAVIOR AND COOPERATION

 She is slightly disheveled wearing sweatpants and a hood over her head
 And displaying lack of eye contact and psychomotor retardation

2nd VISIT

AFFECT AND MOOD

 Robbin once again displays anhedonia and a flat/constricted affect
SUICIDALITY
 On her second visit Robbin is endorsing passive suicidal ideation
APPEARANCE
 Robbin seems a bit distressed, she is no longer disheveled, she is making good eye contact, and
seems to be a bit more conversational (i.e.: no psychomotor retardation).

3rd day visit

AFFECT AND MOOD

 Robbin’s mood is very labile throughout the conversation, going from euphoric to agitated. And
switch to mania
   She is very euphoric/manic and displays grandiose delusions

SPEECH
 She displayed pressured speech
COHERENCE
 AND loosening of associations, and a tangential/circumstantial thought process.
OBSSESIONS
 Robbin begins to be sexually inappropriate towards the therapist
APPEARANCE, BEHAVIOR AND COOPERATION
 She is abnormally dress
 She is also displaying abnormal eye contact
 Throughout the conversation she displays akathisia/psychomotor activation,
 She gets too physically close to him (abnormal physical proximity)

Name of Case: Ben 

Clinical Diagnosis: Obsessive Compulsive Disorder (OCD)
Obsessive-compulsive disorder (OCD) is a mental illness that causes repeated unwanted
thoughts or sensations (obsessions) or the urge to do something over and over again
(compulsions). 

1st day of visit

OBSESSION
 He has concerns regarding environmental, food, and household contaminants
Compulsion
 He excessively wash his hands
APPEARANCE, BEHAVIOR AND COOPERATION
  Ben does display neck and eye tics throughout the conversation (excessively blinking and tilting
his head towards his shoulders)
*overall ben is pleasant and cooperative and display minimal symtopms

2nd day visit

OBESSION
 Ben is displaying pathological obsessions regarding contamination and somatic illness
 he is also displaying some self-questioning and doubt about his physical symptoms
COMPULSIONS
 Ben’s compulsive checking of these buildings, as well as his internet searches regarding the
chemicals
 he is not displaying any delusions or psychotic features, his obsessions have turned into
pathological doubting and led to compulsions in the form of repeated checking, organizing, and
ordering and reordering
APPEARANCE, BEHAVIOR AND COOPERATION
 He displays akathisia, uneasily sitting in his chair, and has neck and eye tics throughout the
conversation.
3rd day visit
OBSESSION
 he is afraid of interacting with female coworkers out of fear that he will say something
inappropriate (an obsession in the form of sexual/forbidden thoughts)
COMPULSION
 He is constant compulsive cleaning his desk and computer
DELUSION
 Ben’s contamination/environmental obsessions as well as his somatic obsessions have turned
into somatic delusions
SPEECH
  Ben’s speech becomes pressured as he complains of having bloating and nausea, due to a
tumor in his stomach.
APPEARANCE, BEHAVIOR AND COOPERATION
 On initial appearance, it is apparent that his akathisia is worse than before (he is anxiously
moving his right foot up and down and is nervously wringing his hands).
 In addition, his grooming and hygiene are inappropriate (messy hair, wrinkled shirt, etc.) and he is
displaying more prominent neck and eye tics