Name:-Tamam bibi

Age:-51 Years
Sex:-Female
Marital:-married
Husband name:-Juma khan
Qualification:-Uneducated
Language:-Pashto
Religion:-Islam
Nationality:-Afghani

Area:-Yaro
Physical appearance:1:-Tribal dress of pashton area.
2:-Hygienic condition is not so well.
3:-Different moles on her face.
4:-She was wearing bangle and rings.
5:-Tradition hairstyle of pashton.
6:-Her complexion was dark.
7:-Her height was normal.

CASE HISTORY
Family history:-

She is married and mother of 11 children. Out of

11 her 3 infants aborted because of domestic violence while 2 died
children after birth. Her 2 sons and 4 daughters are alive. Her one
daughter and a son were married as per their marriage tradition of
Watta,Sata, in which one familys son and daughter are exchanged with
other familys son and daughter. According to her, her husband was a
good man and took care of her, but her children specially the son who
was married through watta,satta he and her wife dont have a good
relation with her. The daughter also do not have good terms with her inlaws. According to her relatives whenever she had any conflict or
argument with her daughter-in-law she used to lock her in a room and
stop giving her food. This is one of the reason that she turned weaker and
weaker day by day and sometimes she usually fainted because of this
condition. She told that she had an arrange marriage. One of her son died
in a road accident, in the age of 22 years the one she loved most. Due to
this sudden incident she is mentally upset and extremely depressed.

Educational history:-She was illiterate but could recite Quran.

Developmental history:-

She grown up in a strict family

environment.

Medical history:- She is major depression patient, but as she came

to know about her problem after the diagnosis, before consulting a
psychiatrist she tried many other methods like herbal and religious
treatments to cure her problem but all proved to be useless for her as
there was no improvement and her disorder was increasing as the days
were passing. When all the other treatments failed, then finally she was
admitted in a hospital for treatment and she is under treatment since last
three (3) months.

Social history: - She like living alone as compared to live with

family and relatives, she dont care about this that she is alone. Also her
familys financial condition is not very strong.

Mood history:- as she is mentally upset so she seemed to be very

irritated and annoyed with our presence and also she was not answering
properly to the questions we were asking from her. But along with
irritated mood she seemed to be very emotional too, as she used to cry
often.

Thoughts:- She has lost her interest in her life and she wanted to die
as soon as possible. She thinks that she is not worth living and also when
she will die nobody will care for it and her absence will not hurt anyone.
She is unable to concentrate on things and this indicates that she is
having a memory disorganized problem also.

Speech:-when she was being observed she speak incoherently, but

not irrelevant while the patients attendant reported that the client had
been practicing irrelevant speech at home, which shows a loose
association in her thoughts.

Physiological problem:-She was suffering from headache body

ache, her body was shivering also she has the problem of constipation,
high blood pressure and severe weight loss due to which she was very
thin and weak.

Concentration attention:-She was in aggressive mood and

unable to concentrate on things around she was not concerned with her
surroundings and whatever was happening on the spot.

Medical history:- along with depression she is suffering from high

blood pressure and according to her she feel pain in her whole body. She
is under the treatment of her medical advisor Dr. Jahangir khan.

Psychological problem:-According to DSM-4 with diagnosis that

my patient is suffering from major depression.

Psychiatric treatment: Doctor name: - Dr. Ghulam Rasool.

Medicine: Electric shock treatment.

REPORT WRITING
At 10:00 AM we left for Bolan medical complex hospital from SBKWU by
bus. When we reached the hospital we had to find the way to the
psychiatric ward, after we found the ward we entered the gate of the
ward, this ward is located at the back side of the main campus of BMC
hospital. Our supervisor Madam Nargis talked to the doctor about the
matter and the reason of our presence there. We were asked to wait in
the conference room. The chairs in the room were seemed like they were
not cleaned for a long time. After waiting for half an hour the doctors
thoroughly briefed us about the whole set up of the psychiatric
department. Then we went to visit the male and female ward one by
one .In male ward there were four patients, whereas in female ward five
patients were admitted. Our class was divided in three groups and each
group was assigned to investigate and inquire one particular disorder.
Specific patients were assigned to each group then after taking
permission from our supervisor we left for wards to collect the required
information about our case of depression in order to complete our task.

The patient assigned to our group was named Tamam Bibi, she was 51
years old. She was an old women then we took the history of Tamam bibi
from her doctor in written form, from which we came to know about her
We tried to talk to Tamam bibi but she looked quite isolated and didnt
even answered the question, her attendant told her name and told that
she belong to the tribal area of Afghanistan. The patient according to her
attendant belong to a low socioeconomic class and it was reported that
the attitude of her family was very rude and harsh with her. Also it was
told that once the patient had a disease of anti-melena and her family
took her to Karachi and the doctor there told them that the patient had a
mental disorder and when she was back to Quetta, as the time passes
slowly and gradually she start saying that that she hear different voices
and usually see ghosts roaming around but nobody from her family cared
about her and ignored whatever she used to say. This ignorance lead her
disease to become more severe day by day and her condition turned
worst.

DISCUSSION
Though in present time mentally ill individuals are treated more
humanistic ally yet. It does not mean that society has accepted mentally
ill individuals as they accept individuals suffering from other physical
diseases, still people who are mentally disturbed experiences prejudice
and biasness from the surrounding. People usually call them mad and
many other words In order to show them down and feel bad for the thing
they are not responsible for.
The people suffering from mental disturbance problems usually needs

more care and attention but the psychiatry ward of BMC presented an
opposite picture. The overall setup there was not very well organized as it
should be. The nursing staff in any hospital plays an important role in
healing the patients but there the nurses were also not well organized.
The above discussion meant not to degrade anyone or any department
its just an attempt to highlight that changes are required to make the
department work more efficiently and provide better services to patients
because the department needs to provide much better facilities as it is
being providing now.
The bitter reality can never be blinked that we as professionals just strive
to pay the require duty. The professional never take omission of human
services. Because omitting this responsibility is one among the causes
which supports the rapid spread of psychological disorder.
Above all the bitterest and most shocking truth is the deliberate
avoidance of appointing psychologists besides psychiatrists at the mental
hospital or at the psychiatric department of the hospitals.
If the proper initiative is taken to provide better facilities, the present
mental health situation must improve greatly.
Spreading awareness among the masses
and prevention of psychological disorders,
at the district based hospital along with
proper training to the nursing staff and
patients in mental or psychiatrist ward will
problems.

regarding the causes, nature

appointment of psychologists
a psychiatrist and by giving
the care shown by them to
surely help in overcoming the