Schizophrenia Case Study

Introduction The patient M. is a 26 year old married female who was brought to the ER by her husband after increased anxiety and depression worsened after a “spiritual attack” that lasted for over four days. While in the ER the patient admitted to hearing multiple distant male and female voices all around her head and outside of her head. She states not being able to make out the message but interprets them to be negative in nature. She told the ER Doc she felt people were trying to harm her and that “people in her life have used things against her.” She felt her extended family may have used witchcraft and “chakra dolls” to cast spells on her. She is cognizant of the strangeness of her claims but believes them to be real nonetheless.
Past Medical/Psychiatric History Her current hospitalization on 9/22/12 was preceded by her first ever admit to any psychiatric unit on 9/11/12. Worsening depression and anxiety with the arrival of psychosis: auditory, visual hallucinations and paranoid thoughts caused her to seek treatment on 9/11. Her first inpatient stay was cut short because a medical workup by HMS detected a pulmonary embolism. She was transferred to a medical floor, where she was treated with warfarin and coumadin until her INR levels reached a normal range of 2.4. She has since been transferred back to the inpatient psychiatry service for continued treatment of her psychosis. She has been treated for bipolar, anxiety and OCD. She has history of attending marriage counseling with her husband. M. has a history of chronic back pain that caused her to take leave from her job as a librarian. She has been unemployed for two years. Her pain was initially treated with opiod painkillers, which she later became addicted to. She attended rehab in 2008 and completed detox from opioid painkillers. She attributes her recent exacerbation of anxiety to an increase in her back pain. The current episode of paranoia and