hebephrenic (disorganized) and post schizophrenic depression

its about some subtype of schizophrenia along with the case studies.

1. Group Erikson SAYANTAN SUBARTA SUPARNA SUKANYA ANJALI SIDHARTH Hebephrenic schizophrenia Post schizophrenic depression

2. Hebephrenic schizophrenia It is also called as Disorganised Schizophrenia which is one of the subtypes of Schizophrenia, characterized by disorganised thought, behaviour and speech which affects in emotional regulation. People living with disorganised Schizophrenia often shows little or no emotions in their facial expressions, voice tone or mannerism . Disorganised Schizophrenia is associated with early onset, between the ages of 15-25yrs. Earlier age of onset is traditionally associated with a worse prognosis due to lower educational achievement, more prominent negative symptoms and cognitive Impairment. This is the type which has the worst outcomes and prognosis. Only early detection, diagnosis and treatment of the disorder contributes to better outcomes.

3. Clinical picture of hebephrenic schizophrenia A person who is experiencing hebephrenic (disorganized) type of schizophrenia may show symptoms of the following for a significant portion of the time over a 1-month period Symptoms include disorganised behaviours (without any purpose) and thoughts, which is difficult to understand by others. Loosened associations, schizophasia ("word salad"), and flat or inappropriate affect are present . Pranks, giggling, grimacing, mannerisms, inappropriate laugh are common. Hallucination and delusion are fleeting. There is a complete lack of emotion, including anhedonia (lack of pleasure), and avolition (lack of motivation). Personal hygiene and contact with reality are poor.

4. Case study Case Presentation: A 22 years old girl was brought to the DHQ hospital Faisalabad by her parents with the presenting complaints of self-talk and self-laugh. They reported that their daughter suspects that somebody has casted a black magic on her. She even skips her meal with a suspiousness that someone has poisoned her food. She was experiencing all the above complaints from at least past one year. On inquiring her no significant family history was found related to this disorder. Past History: 3 years ago she was brought to the DHQ hospital Faisalabad when antipsychotics were prescribed to her. But she stuck to the regimen just for one year. General Examination Special Investigation Weight: 46kg B.P: 110/ 70 Temperature: 98 F Pulse Rate: 63 beat per minute Mental state examination ( appreance , mood, behavior): neglected self-care, looking around, rapport and eye contact was not established. Non cooperative behavior throughout interview. Positive and Negative symptoms scale (PANSS): delusions, hallucination, poverty of speech, disorganized behavior.

5. Post schizophrenic depression post-schizophrenic depression has become officially recognized as a syndrome and is considered a sub-type of schizophrenia in ICD-10. It is a "depressive episode arising in the aftermath of a schizophrenic illness where some low-level schizophrenic symptoms (positive & negative) may still be present .” Someone that suffers from post-schizophrenic depression experiences both symptoms of depression (depressive being prominent & manic ). These depressive states are associated with an increased risk for suicide.

6. Clinical picture of Post schizophrenic depression A number of researchers believe that depression is actually a symptom of schizophrenia that has been hidden by the psychosis . However , symptoms usually arise after the first psychotic episodes if they will arise at all . Formally, diagnosis entails the patient having had schizophrenia within the past year, a number of schizophrenic symptoms, and depression being present for two weeks or more. Officially, diagnosing post-schizophrenia depression in a patient requires for the patient to be experiencing a depressive episode of either short or long term following the overcoming of schizophrenia. The patient must still demonstrate some schizophrenic symptoms but those symptoms must no longer be the focus of the illness. Typically, the depressive symptoms are not severe enough to be classified as a severe depressive episode. Mild schizophrenic signs may be withdrawing socially, agitation or hostility, and irregular sleep such as in the case of insomnia and hypersomnia.

7. Case study The final autopsy report, released in November 2014 , affirmed that Williams had committed suicide as initially described; neither alcohol nor illegal drugs were involved, while any prescription drugs present in Williams ’ body were at “therapeutic” levels. The report also included that Williams had been suffering from a recent increase in paranoia . A careful examination of the life of the apparently pleasant , funny, and happy Robin Williams indicates that he was indeed suffering from major depression, alcoholism, drug abuse, financial problems, serious relationship issues leading to multiple divorces, and Lewy body dementia, all of which are considered risk factors leading to attempted and successful suicide In this case. His symptoms, as described, also point toward a possibility of acute psychosis, although this diagnosis remained unconfirmed. . The world renowned comedian and four-time Oscar nominated actor Robin Williams died on August 11, 2014. William’s assistant became worried due to his lack of response to text messages and phone calls and later found him hanging by a nylon belt in a closet door frame, with superficial cut marks on the inside of his left wrist He was pronounced dead, the news indicated that his death was believed to be a suicide. He had recently been diagnosed with Parkinson’s disease. A medical history taken by authorities revealed that he also had recent symptoms of paranoia and hallucinations. According to the actor’s wife, his pre-suicide activities included placing some wrist watches in a sock and dropping them off to keep them safe, which could be considered bizarre behavior.