what is a famous case study of schizophrenia

Module 11: Schizophrenia Spectrum and Other Psychotic Disorders

Case studies: schizophrenia spectrum disorders, learning objectives.

• Identify schizophrenia and psychotic disorders in case studies

Case Study: Bryant

Thirty-five-year-old Bryant was admitted to the hospital because of ritualistic behaviors, depression, and distrust. At the time of admission, prominent ritualistic behaviors and depression misled clinicians to diagnose Bryant with obsessive-compulsive disorder (OCD). Shortly after, psychotic symptoms such as disorganized thoughts and delusion of control were noticeable. He told the doctors he has not been receiving any treatment, was not on any substance or medication, and has been experiencing these symptoms for about two weeks. Throughout the course of his treatment, the doctors noticed that he developed a catatonic stupor and a respiratory infection, which was identified by respiratory symptoms, blood tests, and a chest X-ray. To treat the psychotic symptoms, catatonic stupor, and respiratory infection, risperidone, MECT, and ceftriaxone (antibiotic) were administered, and these therapies proved to be dramatically effective. [1]

Case Study: Shanta

Shanta, a 28-year-old female with no prior psychiatric hospitalizations, was sent to the local emergency room after her parents called 911; they were concerned that their daughter had become uncharacteristically irritable and paranoid. The family observed that she had stopped interacting with them and had been spending long periods of time alone in her bedroom. For over a month, she had not attended school at the local community college. Her parents finally made the decision to call the police when she started to threaten them with a knife, and the police took her to the local emergency room for a crisis evaluation.

Following the administration of the medication, she tried to escape from the emergency room, contending that the hospital staff was planning to kill her. She eventually slept and when she awoke, she told the crisis worker that she had been diagnosed with attention-deficit/hyperactive disorder (ADHD) a month ago. At the time of this ADHD diagnosis, she was started on 30 mg of a stimulant to be taken every morning in order to help her focus and become less stressed over the possibility of poor school performance.

After two weeks, the provider increased her dosage to 60 mg every morning and also started her on dextroamphetamine sulfate tablets (10 mg) that she took daily in the afternoon in order to improve her concentration and ability to study. Shanta claimed that she might have taken up to three dextroamphetamine sulfate tablets over the past three days because she was worried about falling asleep and being unable to adequately prepare for an examination.

Prior to the ADHD diagnosis, the patient had no known psychiatric or substance abuse history. The urine toxicology screen taken upon admission to the emergency department was positive only for amphetamines. There was no family history of psychotic or mood disorders, and she didn’t exhibit any depressive, manic, or hypomanic symptoms.

The stimulant medications were discontinued by the hospital upon admission to the emergency department and the patient was treated with an atypical antipsychotic. She tolerated the medications well, started psychotherapy sessions, and was released five days later. On the day of discharge, there were no delusions or hallucinations reported. She was referred to the local mental health center for aftercare follow-up with a psychiatrist. [2]

Another powerful case study example is that of Elyn R. Saks, the associate dean and Orrin B. Evans professor of law, psychology, and psychiatry and the behavioral sciences at the University of Southern California Gould Law School.

Saks began experiencing symptoms of mental illness at eight years old, but she had her first full-blown episode when studying as a Marshall scholar at Oxford University. Another breakdown happened while Saks was a student at Yale Law School, after which she “ended up forcibly restrained and forced to take anti-psychotic medication.” Her scholarly efforts thus include taking a careful look at the destructive impact force and coercion can have on the lives of people with psychiatric illnesses, whether during treatment or perhaps in interactions with police; the Saks Institute, for example, co-hosted a conference examining the urgent problem of how to address excessive use of force in encounters between law enforcement and individuals with mental health challenges.

Saks lives with schizophrenia and has written and spoken about her experiences. She says, “There’s a tremendous need to implode the myths of mental illness, to put a face on it, to show people that a diagnosis does not have to lead to a painful and oblique life.”

In recent years, researchers have begun talking about mental health care in the same way addiction specialists speak of recovery—the lifelong journey of self-treatment and discipline that guides substance abuse programs. The idea remains controversial: managing a severe mental illness is more complicated than simply avoiding certain behaviors. Approaches include “medication (usually), therapy (often), a measure of good luck (always)—and, most of all, the inner strength to manage one’s demons, if not banish them. That strength can come from any number of places…love, forgiveness, faith in God, a lifelong friendship.” Saks says, “We who struggle with these disorders can lead full, happy, productive lives, if we have the right resources.”

You can view the transcript for “A tale of mental illness | Elyn Saks” here (opens in new window) .

Candela Citations

• Modification, adaptation, and original content. Authored by : Wallis Back for Lumen Learning. Provided by : Lumen Learning. License : CC BY: Attribution
• A tale of mental illness . Authored by : Elyn Saks. Provided by : TED. Located at : https://www.youtube.com/watch?v=f6CILJA110Y . License : Other . License Terms : Standard YouTube License
• A Case Study of Acute Stimulant-induced Psychosis. Authored by : Ashley Henning, Muhannad Kurtom, Eduardo D. Espiridion. Provided by : Cureus. Located at : https://www.cureus.com/articles/17024-a-case-study-of-acute-stimulant-induced-psychosis#article-disclosures-acknowledgements . License : CC BY: Attribution
• Elyn Saks. Provided by : Wikipedia. Located at : https://en.wikipedia.org/wiki/Elyn_Saks . License : CC BY-SA: Attribution-ShareAlike
• A case report of schizoaffective disorder with ritualistic behaviors and catatonic stupor: successful treatment by risperidone and modified electroconvulsive therapy. Authored by : Yuanhan Bai, Xi Yang, Zhiqiang Zeng, and Haichen Yangcorresponding. Located at : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851085/ . License : CC BY: Attribution
• Bai, Y., Yang, X., Zeng, Z., & Yang, H. (2018). A case report of schizoaffective disorder with ritualistic behaviors and catatonic stupor: successful treatment by risperidone and modified electroconvulsive therapy. BMC psychiatry , 18(1), 67. https://doi.org/10.1186/s12888-018-1655-5 ↵
• Henning A, Kurtom M, Espiridion E D (February 23, 2019) A Case Study of Acute Stimulant-induced Psychosis. Cureus 11(2): e4126. doi:10.7759/cureus.4126 ↵

8 Clinical Cases of Schizophrenia (Extremes)

Knowing the 8 cases of schizophrenia that I will show you in this article article will help you to better understand this mental illness; Its symptoms, characteristics and the people who have it.

The schizophrenia Is a chronic mental disorder that affects approximately 1% of the population. When it appears it is characterized by hallucinations, delusions, disorganized thinking, altered language, attention problems, lack of motivation and emotional distress (American Psychiatric Association).

The tendency to develop schizophrenia is inherited genetically and may or may not arise depending on many more factors, such as lifestyle, personality or experiences.

Currently there is no cure for this condition, but it can be greatly improved if adequate therapy is found for each person, including always pharmacological treatment (usually antipsychotics or neuroleptics).

For a better understanding of the symptoms of this disease, I recommend reading these 8 real cases:

1. The case of Stuart

It all started in 1991, when Stuart traveled to Moscow to go to a march against communism. It was a rather tense moment in history, as the communists were attempting to stage a coup against Mikhail Gorbachev, the president of the Soviet Union at the time.

Stuart claims that a very angry Russian man called him that night at dawn. The unknown man cursed and shouted at him, asking him why he had gotten into his affairs. Stuart, very frightened, hung up the phone.

From that moment on, he began to feel fear because he could not stop thinking that he was being investigated. When he returned to London, he was always stressed because he felt persecuted, over time developing a depression .

Stuart lost his job shortly before his first psychotic outbreak, which he described as: "It was horrible, I think it appeared out of sheer stress and anxiety. I was lying on the bed when suddenly I felt a pressure on my head, and then, a total darkness. It was as if my own mind had aspired to me, losing all sense of reality. I screamed, and suddenly I went back to my room with that strange feeling in my head."

Later he moved a couple of times, in order to flee from those who were supposedly chasing them. Desperate, one day he went to the family doctor, who did not hesitate to send him quickly to a psychiatric team.

He was diagnosed with schizophrenia, and after testing several treatments, they found a drug that helped him. Stuart stopped experiencing the symptoms: he discovered that no one was chasing him, it was only the result of his illness. He felt much better, with new life plans and goals, like climbing Everest.

He wants to convey to the world that, despite what they say, recovering from schizophrenia is possible.

2. The man who feared being homosexual

The origin of this history can be located in 1972, when a patient with 23 came to consult for fear of being homosexual. He indicated that he was very scared since he heard voices that spoke to him of the subject.

He was diagnosed homosexual panic and paranoid schizophrenia, and a treatment was started to eliminate his fears and hallucinations. Over time, he managed to accept his homosexuality, presenting a double identity: masculine and feminine, which fluctuates according to the time in which he is. Sometimes he would dress in women's clothes or wear women's underwear, surprising why people did not look at him from the street.

Subsequently, he began to have promiscuous relationships with homosexuals, drug addicts, thieves and exploiters. One day, while he was drunk, he pushed one of these into the void from his house, dying on the spot. He was detained for 6 months. However, they declared it unimpeachable.

This patient had problems with alcohol, and although he received financial aid, he had numerous debts because he spent much more than he received.

He spent most of his time writing about the"Principality of Naranjo Bay,"a place he claimed existed. He keeps a daily record of what was happening in the principality and gave it to the doctor after each consultation to be kept in the library of the Psychiatric Institute. The objective of this patient was to demonstrate that, within 100 years, psychiatrists read and confirm that he does not have schizophrenia.

The curious thing about this case that surprised the psychiatrists was the absence of hallucinations and the predominance of inventions, fantasies and delusions. In addition, he reasoned adequately on any subject that was not related to his delusions. For this reason, many classified it as a rare form of schizophrenia called schizophrenia, or Paraphrenia .

It seems that this man remained in treatment, with stable results.

3. Antonio, the boy who thinks he's an alien

At age 14 Antonio appeared in consultation accompanied by his parents. They said the beginning was when Antonio, 12, started talking to his friends about aliens.

From then on they began to see him sad, frightened and suspicious; And before long he was convinced that both he and his family were aliens. For this reason, he received medication , Although his obsession with UFOs remained.

He presented a rather strange way of speaking, which is associated with schizophrenia: unorganized language, jumping from one subject to another that has nothing to do with it, difficulty in finding the word he wants to say, or not responding concretely to what he is told Question.

In addition, it is not expressive, does not usually look at the face, and has A very low self-esteem .

Together with this, Antonio began to develop a Obsessive compulsive disorder , Which can be identified through"manias"and rituals. For example, washing your hands continuously, watching your body a lot, thinking that something terrible is going to happen if you do not turn off the lights or close the door to your room... which sometimes does not leave you To fall asleep .

He was diagnosed with disorganized type schizophrenia, establishing a treatment with his family to strengthen ties, Cognitive therapy , Training in social skills , Techniques to avoid relapse, Neuroleptic medications Y Antidepressants , among others.

4. Jack's Case

Jack graduated from high school and got a job at a video store. After six months of being there, he began to hear voices telling him that he was not doing things right.

In addition, he began to think that his boss was placing small cameras in the movies that clients returned to verify if he did his job well. Thus, Jack was becoming more worried and anxious in his work, especially the days when the store was fuller.

Little by little he began to talk strangely to clients, even told one of them that he could not book the movie he wanted because he had pictures of him that the CIA was reviewing.

A year later Jack could not stand it anymore and quit his job, shouting to his boss that he was sick of watching over all the screens in the store and even in his own house.

He returned to live in the house of his parents, and a while later he was admitted to the hospital. They tried to treat him with various drugs, but he was not persistent, since they had many side effects.

During the next 7 years he was hospitalized 5 times, until he found a treatment that was able to help him.

Finally, he began attending a club for people with mental illness 3 times a week, attending the telephone and participating in the local newspaper. In addition, he feels totally qualified and motivated to look for a work related to the cinema.

5. Susana, the girl of the robots

Susana is a 15 year old girl who her teachers describe as difficult, violent, underperforming in school, and who often interrupts in class telling stories and making animal sounds.

It seems that the problem manifested itself from the age of 12, having been from a girl something different from the others. Since going to the movies to watch Star Wars, he has a great obsession with robots, so he spends the day talking about related topics and drawing futuristic spaceships and inventions.

Susana explains that she has an incredible gift that no one has yet discovered. She says that she makes robots with pieces of computers, and that she once almost caused a catastrophe with one of them, although she managed to stop it in time.

However, when asked how it works or how it was built, it does not know how to respond accurately. She begins to relate random mathematical procedures that make no sense, considering herself as a genius. In psychology, this is called delirium .

In addition, he presumes to have the gift of hearing voices that no one hears and speaks with beings from another world. Experts rate this as Auditory hallucinations .

However, the family did not clearly appreciate the problem and thought they were minor children's stories.

A pharmacological intervention, cognitive therapy, psychoeducation, family intervention and social skills Surely the state of Susana improved.

6. Eva, a girl with paranoid schizophrenia

Eva was 10 when she claimed she could hear voices. The voices told her she was going to die soon because other people have committed crimes because of her.

And he also thinks that, through his breathing, he is able to handle other people. On the other hand, he believes that they record it on video continuously with the aim of putting them on sale.

To make matters worse, she is convinced that others can read her mind, look at her and pursue her. This gives you discouragement and sadness.

Eva presented problems from the age of two, more specifically, developmental delay and communication disorder.

As for her family, her mother apparently had schizophrenia, and when Eva was five, her parents separated and a new family welcomed her. At this age developed many phobias, problems to relate to others, developmental delay and hypersexual behaviors for their age. Surely that form of upbringing was not healthy for the little girl.

After being diagnosed paranoid schizophrenia , A very complete treatment was carried out which probably made her improve in all aspects.

7. Schizophrenia is discovered in a boy who demanded therapy for pain in the shoulder

A 19-year-old boy was referred to physical therapy because of chronic pain in the shoulder, elbow and wrist. It seems that he had bruises since in his spare time he used to skate, snowboard, and break dance, as well as weight training.

In the past, he had gone more than 10 times to the same clinic of sports medicine, diagnosing a great amount of physical affections provoked by the sport.

The pain was real, however, this indicated that the discomfort was due to an electronic device that the United States government had implanted two years ago to control him. He was convinced that the electromagnetic impulses of the device had caused them to fall and injure.

In addition, he said that when he was doing something that the government did not like (according to the patient, his sports activities), his joints cooled or began to hurt. On the other hand, he began to hear voices ordering him to harm his friends or relatives, but he blamed it on the electrical device.

He also thought that other people around him had implants similar to his own to be controlled. He indicated that these people emotionally abused him, gesturing to him to make him understand that they were being watched.

The therapist was able to identify that it was a mental condition and immediately sent it to the psychiatrist. He was diagnosed with schizophrenia and prescribed Risperdal , a known Antipsychotic medication .

Through this case, Shah and Nakamura (2010), insist on the importance of all health professionals to know the signs and symptoms of schizophrenia and other mental health problems. And of course, they stress the importance of in-depth interviews in patients with musculoskeletal discomfort.

8. Álvaro, a young man with behavior problems

Did you know that schizophrenia also alters the way you talk, gestures and movements?

These are the main symptoms of schizophrenia presented by Alvaro, a 17-year-old boy who came to Mental Health for behavioral disorders. For example, he was so aggressive with his mother that she had to call the police several times.

Álvaro left the studies and seems to be a young retired, distrustful and of lost look.

What appeals to the psychiatrist is his gestures: he presents Stereotyped movements (Repetitive movements that are not useful, such as touching clothes, or any part of the body, or swinging). In addition to involuntarily imitating the movements of the people around him ( Ecopraxia ) And making strange grimaces.

Other symptoms of schizophrenia that it presents are reduced language, with phrases made and, above all, to repeat what the examiner says (what is called echolalia).

• Escobar M, Enrique, & Barra C, Bernardo. (2011). History of a case with schizophrenia, or fantastic and systematized paraphrenia. Revista chilena de neuro-psiquiatría, 49 (2), 177-181.
• Childhood schizophrenia. Clinical cases. (S.f.). Retrieved on October 28, 2016, from Paidopsychiatry Portal.
• Rose, M. (s.f.). Schizophrenia: Case study. Retrieved on October 28, 2016, from Collin College.
• Schizophrenia - Stuart's story. (S.f.). Retrieved on October 28, 2016, from NHS Choices.
• Shah, N., & Nakamura, Y. (2010). Case Report: Schizophrenia Discovered during the Patient Interview in a Man with Shoulder Pain Referred for Physical Therapy. Physiotherapy Canada, 62 (4), 308-315.
• What Is Schizophrenia? (S.f.). Retrieved on October 28, 2016, from the American Psychiatric Association.

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