Interpretation of schizophrenia cases

The basic situation of the patient and the process of diagnosis and treatment

Patient Chen XX, female, 46 years old, unemployed
.

History of present illness: The patient suffered from mental abnormalities without obvious inducement 10 years ago, and he heard the voice out of thin air, saying that he heard the voices of former working colleagues in his ears, suspected tracking, suspected harm, and felt that former working colleagues were following her.
She often patrols at home, and sometimes suddenly yells "Friends in Dongguan, come out.
" She once went to a local hospital.
The specific diagnosis and treatment is unknown.
After treatment, the patient's condition improved slightly, and the medication was stopped by herself due to tremor
.

Past history, personal history, family history: nothing special
.

Physical examination: T 36.
3 ℃, P 80 beats/min, R 20 beats/min, BP 90/70 mmHg, Shenqing, bilateral pupils with equal circles, sensitive to light reflection, no obvious abnormalities in cardiopulmonary auscultation, soft abdomen , No tenderness and rebound pain, free movement of the limbs, normal muscle strength and muscle tension , no resistance in the neck, the existence of physiological reflexes, and negative neuropathological signs
.

Mental examination: clear consciousness, well-dressed clothes, accurate orientation, concentrated attention, passive contact, slightly slow thinking and association, auditory hallucinations, self-reported that the "thousand-mile transmission" can be heard in the brain, and many people are talking and telling A chip is installed in her body and there are monitors around her, so she dared not eat, had delusions of being persecuted, and told her neighbors are good and bad.
When mentioning the specific content of "neighbors are good and bad", the patient skipped the topic and did not go further.
Description: The emotional response is flat, the volitional activity is pathologically reduced, and there is no impulsive self-injury, suicidal behavior, and no insight
.

Laboratory examination: No abnormalities in blood routine, no obvious abnormalities in electrolytes, lung and kidney function, myocardium and blood lipids
.

Diagnosis : ICD-10: Schizophrenia
.

After treatment:

The patient took amisulpride 0.
4 g/d at the time of admission.
Symptoms such as hallucinations and delusions of persecution were reduced, but adverse reactions such as hand tremor and restlessness occurred, and menstrual flow was significantly reduced.
The treatment plan was required to be changed
.

Switch to lurasidone treatment
.

Current condition: The patient's hallucinations and delusions of persecution have basically disappeared, and the patient can complete housework normally
.

Treatment discussion

Increased levels of prolactin and menopause are one of the common adverse reactions of antipsychotics, especially amisulpride
.