Psychiatric report

(interviewed on october 14 2015 ) Azin deldar Group 10

Personal data

Name: ILONA
Age: 73
Address: lives in Debrecen
Gender: female
Place of birth: polgár
Marital status: single. Divorced
Occupation: retired now. But worked as a store manager
Highest level of education: collage . Economics study and finance speciality

Circumstances of admission

The patient was admitted to the ward because she was experiencing delutions such that her home was infested with bugs coming from bird netsts that had been removed from the deforeastaation over the summer. She was admitted to the ward by her by her psyciatrist and she came in alone. Her date of admission was on october 9th 2015. Year 2005 she was treated in Kenezy hospital due to some family problems. In just that year she lost six of her close family members. In 2003 she was experiencing panic attacks and 2005 she was diagnosed with major depressive dissorder.

Autoanamnesis

Her current complaint were due to the bugs in her home. By the end of june a bird nest was found and later removed from a chimney in her home. She cleaned everything up but again next day they appeared again on her butter and toast. She was afraid of them due to health concerns. The patient told us that the bugs but her back ones and it got infected. After that she went to the family physician and got some steroid cream. Her symptoms appeared due to sleeping disturbances, she had trouble falling asleep at night time, she took sleeping medication to help her fall asleep such as mitrazapin which has a dual action of antidepression. She was took it every evening and it would last for 34 hours. Because of the feae of bugs she would check her clothes every morning and look for blood that mau be caused by the bugs. The patient had sleeping disturbances for twelve years. She wakes up in the middle of the night with panic attacks as well as she experiences night sweats and she also experince feelings thats she is going to die. The patient has premorbid personality, she said she was very good with people and she had lots of friends, but unfortunately all of her friends died. She used to be very clean, ordered as well an organized person.

Medical history

At the age of 12 the patient had tonsilectomy and by 17 yeats she pleuritis. She had cholecystitis and cholelithiasis and she ERCP two years ago from jaundice. Her psychiatric illness in 2003 we were worried about her having myocardial infarction because of her panic state. By the suggestion of her frind she went to see a psyciatrist who was a physician as well and she was diagnosed with depression. In 2005 she wsa diagnosed with major depressive disorder.

Gynecological anamnesis

By the age of 13 the patient got her first menstruation and the one was at the age of 53. The mentrual cycle was regular eaithout any kind of abnormalities. She had two pregnancies, one was by the age of 21 and she had a spontaneous abortion. Her second pregnancy was by theage of 22, she got a girl, iti resulted in an vaccum assisted pregnancy because she was not dilating.

Medication

In her current state she is taking xanax for her anxiety and mirtazapine for her depression and lseeping disorder. She was taking one in the evening that acts for about twentyfour hours. She took all the drrugs prescribed dosage. She is allgergic to norfloxacin and ciprofloxacin with severe dermatological symptoms. She also has some allergies to some foods.

Consumer goods and enviromental effects

The patient does not drink alcohol and she does not use any drugs. She used to drink coffe when she was young but she di not drink anything other than that.

Family history

The patient's father passed away at the age of 87 due to a stroke and her mother also passed away at the age of 87 due to breast cancer. Her brother died from lung cancer cause he was a heavy smoker as well as an alcoholic. Her cousin from her mother's side comitted suicide. There was no mental disorder or suicide reported.

Biography

The patient had good relationship with her parents specially her father. When she was a child her brother had meningitis so her mother tended to focus more on her brother because he was sick. At that time she was six and her brother was eight. This affected her in a way that she felt like she had to prove herself to her mother. Her mother herself was a strict woman. Her parents relationship was not so good because her father was popular and a handsome man and mother to be very jeloues over him. In 1952 at the age of 10 years there was a revolution going on in Hungary. Her father was at the working camp and he was there for four years. At that time they had to hide and they lost everything they owned, they were hiding with their friends also for four years. After this her father went to miskolc and worked in a factory and there were a lot of people working there and he could only go to see his his family over the weekends. In her childhood she did not have any illness of any kind and she used to have good reltionship with people, she did well socially. In her school time she was a very good student and she also had many friends. On 1956 she started secondary school and she learned and studied just due to shame that she had but normally she did not enjoy learning. In collage she studied economics and finance and so became a store manager. She enjoyed her job very much. In her childhoos and adulthood she had many friends, only two of them are alive now, she had to marriges, the first was the age of nineteen, and she met her husband at her work and he was a customer. In 1961 they got married and they were together for ten years but only the first year they were good together and then he became alcoholic and she applied to get a divorce. After a few years of being single she got married a second time, and she got married so that her daughter could have a father, she did not get married for love. At the age of 47-53 she had a serious relationship but another woman came in between them and so they got divorced.

Heteroamemnesis

Not obtained.

Physical and mental state examination

General appearance: The patient was dressed clean and neaty and she had clean and fixed hair. She is a little bit underweight but other then that she looked healthy. Behaviour: Generally the patient's behaviour was, she cooperated and enganged in the interview. The patient gave good eye contact and she did not have any motor behaviour disorder. Speech: The rate and quantity and volume of her speech was normal and regular. The tone and content was appropraite wuth the subject in the conversation. Awerness: No flutuation was observed and no abnormal integrantion and vigilance was observed. Appreciation: The patient was asked some some autopsycic questions such as what how old are you? What is your name? What is your occupation? Who are therse people in this room? The patient answered to all of these questions appropriately as well as in a correct manner. She was well oriented In autopsychic and allopsychic and questions about time and place . Appreciation: The patient was asked to stand up and go and open the door, she did it with no problem. She did not show any sings of abnormal appreciation. Attention: The patient's attention was examined with several examinations such as substracting seven from one hundred subsequently, she concetrated well and managed to get them all correct. Memory: To test the short term memory the patient was asked to repeat several different words and she was asked to recall them a few minutes later. It appereared she had short term memory for some foods. For long term memory she was asked to sing one hungarian poet and she was asked to tell the capital city of Germany. The patients long term memory was also in tact and her general knowledge was appropriate to her education. Emotion: The patient was behaving good was seemed happy, she never had suicidal taughts in her life and she also have a friendly personality. Perception: The patient suffers from hallucinations but denies it completely, she believes that other people can see the bugs around her house, she satred to see these hallucinations since summer and have sleeping disturbancies due to this. Thinking: Pateints speech is normal and regarding the emotion expression she participated good and she can stay focused on the subject. Insight: The patient only has partial insight to her illness and she has accepted her psyciatric illness, anxiety and depression but yet denies her hallucinations to bugs Intelligence: The patient's intellectual capacity is in accordance with the level of her education. Söeeping: She has experienced sleeping disturbancies for about twelve years and has been given medication for that from her family doctor. But recently she has had more sleeping problems because of the fact that she is getting disturbed by her hallucinations. Instinctive behaviour: The patient is eating normally and has no disturbancies cocerning her appetite. She did not mention any change in her sexual function.