MENTAL STATUS ASSESSMENT:

A. GENERAL APPEARANCE
The patient grooming was fair after morning care .
Most of the time she exhibited appropriate facial expressions and
posture during interactions and can maintains good eye contacts.
B. MOTOR BEHAVIOR
Throughout the entire days of duty the patient presented
automatism. It is defined as repeated purposeless behavior often
indicative of anxiety such as drumming of fingers, twisting of locks
of hair or tapping of foot. No other motor behavior presented.
C. SENSORIUM AND COGNITIVE
Sensorium and cognitive consists of the assessment of
orientation, concentration and memory. Orientation refers to the
client recognition of person, place, and time. Memory is an
organism’s mental ability to store, retain, and recall information
which is divided into recent and remote memory.

During the 4 day nurse-patient interaction, the patient orientation

and memory are stable. She can retrieve past events and recognize
people around her, she is also acquainted to time, place, and who she
is.
D. PERCEPTION
The patient manifest presence of delusion wherein she stated
that she undergone abortion and she was a battered wife. She also
claim that she was tricked by a tricycle driver to worked as a
“labandera” in VSMMC and that’s the reason she was admitted.

E. ATTITUDES AND BEHAVIOR

Attitude is a position of the body or manner of carrying

oneself. It is a position of the body appropriate to or expressive of
an action, emotion.

The patient exhibited uncooperation and withdrawn social activities

until the termination of her treatment care. It was also observed that
she was evasive with any type of therapy rendered by the Student
Nurses.

F. DEFENSE MECHANISM

Defense mechanism are psychological strategies brought into play

by various entities to cope with reality and to maintain self image.
Healthy persons normally use different defenses throughout life. An
ego defense mechanism becomes pathological only when its persistent
use leads to maladaptive behavior such that the physical and/or mental
health of the individual is adversely affected. The purpose of the Ego
Defense Mechanisms is to protect the mind/self/ego from anxiety,
social sanctions or to provide a refuge from a situation with which
one cannot currently cope.
“http://en.wikipedia.org/wiki/Defence_mechanism’’

The patient manifest denial from day 2 to day 3. No other

defense mechanism observed.

G. AFFECTIVE STATE

Affect refers to the experience of feeling or emotion.[1]

Affect is a key part of the process of an organism’s interaction
with stimuli. The word also refers sometimes to affect display,
which is "a facial, vocal, or gestural behavior that serves as an
indicator of affect." (APA 2006)

Irritability is an excessive response to stimuli. The term

is used for both the physiological reaction to stimuli and for
the pathological, abnormal or excessive sensitivity to stimuli.

Affective flattening is a general category which includes

diminishment of, or absence of, emotional expressiveness.

The patient often shows irritability during the nurse

patient interaction. Sometimes shows flat affect and ambivalence.

H. SPEECH

Speech is the vocalized form of human communication. It is

based upon the syntactic combination of lexicals and names that
are drawn from very large (usually >10,000 different words)
vocabularies.

During the interaction, the patient does not show any

alteration in her speech pattern. She did not experience
verbigeration, aphasia, punning and other speech related
problems.

I.THOUGHT PROCESS AND CONTENT

The patient manifested delusion.

RELATED LITERATURES

Schizophrenia is a mental disorder that makes it difficult to tell

the difference between real and unreal experiences, to think
logically, to have normal emotional responses, and to behave normally
in social situations.

Causes, incidence, and risk factors

Schizophrenia is a complex illness. Even experts in the field are not
sure what causes it. Some doctors think that the brain may not be able
to process information correctly.
Genetic factors appear to play a role. People who have family members
with schizophrenia may be more likely to get the disease themselves.
Some researchers believe that events in a person's environment may
trigger schizophrenia. For example, problems (infection) during
development in the mother's womb and at birth may increase the risk
for developing schizophrenia later in life.
Psychological and social factors may also affect its development.
However, the level of social and family support appears to affect the
course of illness and may protect against the condition returning.
There are 5 types of schizophrenia:
• Catatonic
• Disorganized
• Paranoid
• Residual
• Undifferentiated
Schizophrenia usually begins before the age of 45, symptoms last for 6
months or more, and people start to lose their ability to socialize
and work.
Schizophrenia is thought to affect about 1% of people worldwide.
Schizophrenia appears to occur in equal rates among men and women, but
in women it begins later. For this reason, males tend to account for
more than half of patients in services with high numbers of young
adults. Although schizophrenia usually begins in young adulthood,
there are cases in which the disorder begins later (over 45 years).
Childhood-onset schizophrenia begins after the age of 5 and, in most
cases, after normal development. Childhood schizophrenia is rare and
can be difficult to tell apart from other developmental disorders of
childhood, such as autism.

Symptoms
Schizophrenia may have a variety of symptoms. Usually the illness
develops slowly over months or even years.
At first, the symptoms may not be noticeable. For example, you may
feel tense, or have trouble sleeping or concentrating. You can become
isolated and withdrawn, and have trouble making or keeping friends.
As the illness continues, psychotic symptoms develop:
• An appearance or mood that shows no emotion (flat affect)
• Bizarre motor behavior in which there is less reaction to the
environment (catatonic behavior)
• False beliefs or thoughts that have nothing to do with reality
(delusions)
• Hearing, seeing, or feeling things that are not there
(hallucinations)
• Thoughts "jump" between unrelated topics (disordered thinking)

UNDIFFRENTIATED SCHIZOPHRENIA

The undifferentiated subtype is diagnosed when people have symptoms

of schizophrenia that are not sufficiently formed or specific
enough to permit classification of the illness into one of the
other subtypes.

The symptoms of any one person can fluctuate at different points in

time, resulting in uncertainty as to the correct subtype
classification. Other people will exhibit symptoms that are
remarkably stable over time but still may not fit one of the
typical subtype pictures. In either instance, diagnosis of the
undifferentiated subtype may best describe the mixed clinical
syndrome.