TASK NO.

CASE:
A 25 year-old male was brought in by relatives because he was agitated. For the past three days, he claimed
that the NBI were after him and that his family were in connivance with them. He refused to eat and drink,
claiming that his food is poisoned. He also is seen mumbling to himself, kneeling down as if in prayer, and
saying, "yes, I know. I will follow the aliens in my head. He also refused to take a bath, and barely slept.

When asked by the examiner, the patient kept saying, "The aliens will get you because you are not following
the instructions of the universe, and the NBI will get me because of the aliens in my head."

Medical history is unremarkable, as the patient has no known medical illnesses. He is a non-smoker,
non-alcoholic beverage drinker and is not known to have taken any illicit drugs. They have a family history of
Hypertension, and a maternal aunt was noted to have had a "depression" and was given medications for it.

His father was a meek and quiet man who let his wife dominate him and their children yet patient was closer
to his mother.

What is the cluster diagnosis of this case?

a. What is the genetic basis for Schizophrenia Spectrum & Related Disorders? What specific
gene of chromosome is involved in causing Schizophrenia Spectrum & Related Disorders?
(Biological)
Gene ZNF904a; 22q11.2 chromosome microdeletion

b. Based on Sigmund Freud’s psychosexual stages, at what stage would this patient be fixated?
(Psychodynamic)
sense of loss of reality → oral stage fixation

c. Explain the Diathesis Stress Hypothesis for this disorder. (Biological &
Sociocultural/Environmental)

Genetic vulnerability + stress from environment = schizophrenia

according to the diathesis-stress model, a person who has a genetic vulnerability to Schizophrenia
Spectrum & Related Disorders may not develop the disorder unless they experience significant
stressors in their environment that trigger the onset of symptoms.

d. Describe the Double Bind Theory of Gregory Bateson in explaining the cause of this disorder
in this patient. (Cognitive/behavioral)

contradictory messages from significant others (parents) can lead to confusion, anxiety, and even
psychosis in individuals.

conflicting parental message (father was meek and quiet, while the mother dominates over him) →
child develops into having coping difficulties → child develops schizophrenia symptoms

TASK NO. 2

Give at least 5 symptoms of Depression and give at least 1 cause for each (biopsychosocial) for etiology:

5 Symptoms of Depression:
1. Anhedonia
2. Sexual Dysfunction
3. Over eating
4. Over sleeping
 5. wag fatigue, too similar to sleeping

Etiology:
A. Biological
○ neuroendocrine dysregulation or genetic factors
B. Psychological
○ lack of emotional maturity or inappropriate/incorrect thoughts
C. Social
○ life event and environmental stress (loss of parents before age 11/ loss of spouse)
D. Psychodynamic
○ real or imagined object loss
E. Behavioral
○ learned helplessness

TASK NO. 3

I. Name the Clinical Disorder based on the description.

1. A 25-year old female from Cebu, whose house was complete ruined, but is a survivor of Typhoon
Odette who still exhibits anxiety symptoms described as flashbacks and nightmares, and is especially
afraid at the sound of rain and thunderstorms.- PTSD

2. A 30 year old male young executive who manifests with panic attacks and does not like to go to
crowded places - Panic Disorder

3. A 40 year old housewife who worries excessively about her family, and her health, with a tendency to
think of the worst scenarios in everyday life. - GAD

4. A 27 year old male, first year resident doctor in training, who is unable to be promoted to second year
resident status because he is unable to deliver grand rounds cases, citing intense fear of speaking in
public. - Social phobia

II. What is the ETIOLOGY of Anxiety Disorders?

TASK NO. 4

SUBJECTIVE VS. OBJECTIVE

IDENTIFY/SPECIFY which part of the HISTORY OR MSE are the following items, then SEGREGATE in the
table below if these are part of the HISTORY (Subjective) or the MSE (Objective):

Social History 1. 4 pack years and 3 bottles of beer on the weekends

Chief complaint 2. "Hindi na po siya natutulog at laging balisa"

Concentration and Attention 3. Serial 7's or spelling the word "WORLD" backwards

Perception 4. (-) auditory hallucinations at present

Past Medical History 5. (+) history of asthma, Salbutamol nebulization as needed

behavioral and psychomotor 6. Fine tremors

thought content 7. "Patient graduated from the University of the Philippines, taking up
 Bachelor of Science in Biology, which she finished in 4 years. There
were no academic failures, although patient admits to struggling a bit
with the difficult subjects, particularly Chemistry."

Insight 8. When asked what he thought of his illness, the patient said "Nothing is
wrong with me."
.
HISTORY (Subjective) Mental Status Examination (Objective)

social history concentratiin and attention

chief complaint perception

past medical history behavioral and psychomotor

thought content

insight

TASK NO. 5

MATCHING:
Match the CLINICAL DESCRIPTION with the Somatoform Disorder below:

Clinical Description: Somatoform Disorder:

1. Preoccupation with having or acquiring a serious illness Illness Anxiety Disorder

2. One or more symptoms of altered voluntary motor or sensory function Conversion Disorder /
Functional Neurological
Disorder

3. Presence of one or more somatic symptoms that are distressing or Somatic Symptom Disorder
result in significant disruption of daily life

4. Presence of one or more clinically significant psychological or Pain Disorder

behavioral factors that adversely affect a medical condition by increasing
risk for suffering, death or disability

5. Falsification of physical or psychological signs or symptoms, or Factitious Disorder

induction of injury or disease, associated with identified deception