IDENTIFICATION DATA Soct

Name :Sini Sara Mathew

clewa alata.
SSM
Age :26

Sex
:Female

Marital Status :Single

Education :MBA Graduate

Occupation :Currently Unemployed

Religion :Christian, orthodox

Place of residency :Konni

Socio Economic Status : 25000/month

Date of admission : 16-10-2023

PRESENTING COMPLAINTS AND DURATION

Depressed mood one year and six month

Coplait
Guilt feeling

Carrying out 3months

Death wishes 3week

2wer
Onset: gradual eoolons

Precipitating factor: Difficulties in job ecppla

months
Total duration: One ycar and six
" How such is 4 rupees and 5
nupces?
" If T8 boys are divided into groups of 6, how many groups will
there he

ABSTRACTION

SIMILARTIES

" Orange and Banana Both are fruits

" Dog and Lion 2um mrigangal

"Eve and Ear Human scnsc ofgans

DIFFERENCE
" Stone and Potato Potato is edible,Stone is not cdible

"Cinemaand Radio =Cinema gives visual effect, Radio gives hearing effect

JUDGEMENT

" PERSONAL

Firstlyinced a job and settle then marriage

" SOCIAL

Confhd bctween two people in the society what u do?

1f they are strangers to me,Iwont interrupt the issue

"TEST

Fre nobictm 1f the housc in which you are catches fire, what is the ist thng vå w) d)

Will pout water ot will callfire force

Lettet problem If when vou ate walking nthe thadide \yre a xtanpot and sealod
Which year you passed in 10th? = 2013

INTELLIGENCE
" GENERAL INFORMATION

Name of the Prime Minister? = Narendra Modi

Name of the CM? - Pinarayi Vijayan

Capital of our country? = New Delhi

Name of the Seasons? = Winter, Summer, Rainy

COMPREHENSION

" What will you do when u feel cold?

Sleep in blanket

"What will u do ifit rains when you start to work?

Complete work without getting wet

"What will you do when you miss the bus when you are on a journey?

Wait for next bus

" What will you do when you find on your way that itwill be late by the time you reach

your work spot?

Willtry to reach there as fast as possible

ARITHEMATIC
 "Normal interpersonal relationship with family and society
" Hobbies; watching film
" Mood; worrying or placid unstable mood without occasion

" Attitude is worried by responsibility

" n/h of alcohol and drug abuse

MENTAL STATUS EXAMINATIONS(MSE)

1. GENERAL BEHAVIOUR AND APPEARENCE

Tidy and well kept, awareness of surroundings, minimum rapport established

2. PSYCHOMOTOR ACTIVITY

Normal

3. SPEECH

Only response in questions, little amount of speech, low toned, normal reaction time. its

relevant and coherent.

4. THOUGHT

Depressive ideation, ideas of worthlessness, guilt feeling hopelessness, suicidal ideas

5.MOOD AND AFFECT

"SUBJECTIVE: not interest to do anything

" Objectively; depressive

 "Normal interpersonal relationship with family and society
" Hobbies; watching film
" Mood: worrying or placid unstable mood without occasion
" Attitude is worried by responsibility
"n/hof alcohol and drug abuse

MENTAL STATUS EXAMINATIONS (MSE)

1. GENERAL BEHAVIOUR AND APPEARENCE

Tidy and wellkept, awareness of surroundings, minimnum rapport established

2. PSYCHOMOTOR ACTIVITY

Normal

3. SPEECH

Only response in questions, little amount of speech, low toned, nomal reaction tÉme, its

relevant and coherent.

4. THOUGHT

Depressive ideation, ideas of worthlessness, guilt feeling hopelessness, suicidal jdeas

5.MOOD AND AFFECT

" SUBJECTIVE: not interest to do anything

" Objectively: depressive

No suicide history in family or relatives

Family type, nuclear family

The patient more closed with her

mother and sister

21
PERSONAL HISTORY

" Birth- Caesarean delivery (C-section)

"Developmental milestones reached on time clescipie

" Her menarche was at the age of 12. Regular menstrual cycle.

" Sexual history - Not available

"Marital History- Unmarried

" n/h of substance abuse

PREMORBID PERSONALITY
decreased interest in activities, the patient als0 started experiencing not feeling hungry, 1ee E

and regretful, worried about not getting job in future, had thoughts of death, feeling casily tired. In
the first week of October, the patient attempted to harnn herself by ingesting medications. She was
taken to hospital and was medically managcd. On 16h October, she had cxacerbation of symptoms
along with preoccupation and excessive worry regarding the job, talking irrelevanty, hearing
Somebody telling her that she won't get job and smiling to self,following which she was brought to
the hospital.

PAST ILLNESS & TREATMENT HISTORY

"Medical history: Nomedical history

" Psychiatric history: In the context of joining for a different MBA specialization than she

wishes for, as per her father's decision, the patient had a verbal argument with him and

associatcd emotional distress, for which she sought psychiatry consultation. A session of

counselling was provided to the patient.

FAMILY HISTORY

Father, Mathewkutty T.B, 58/male, MA history graduate, currently unemployed, h/o cancer.

cholesterol

Mother, AnnamaMathew 56/female 10th passed, housewife

Sister, Simi sara Mathew, 27/female nursing completed, currently studying Geman language
No psychiatric history in fámily
 HISTORY OF PRESENTING ILLNESS
c een
The paticnt was apparently doing well until May of 2022, a vear and a half ago. The patient was
employed by Mount Zion Medical College in the human resources department. She received a call
from apatient on April 1, 2022. Because she believed the person on the line to be her friend and was
trying to make her look foolish on April Fool's Day. she misinterpreted the situation and spoke to the
patient as if she were afriend. The patient on thephone unable to comprehend what was happening

complained to the department's HR. The HR requested a justification for her actions toward the
patient. During her course of job, carlier. the HR had also brought up the concern that she sounds
more bass-heavy when speaking with patients while on the job. In addition. she had numerous
nighttime responsibilities, which added to her stress. She. in the aftermath of these stressors,

submitted the justification document along with her resignation later. She had crying spells and was
feeling low. Shewas not feeling like interacting with anyone, was feeling lonely, was not interested
in doing activities. Her sleep and appetite were adequate. She joined as a traince at Pushpagiri

Medical College in June 2022. These symptoms persisted. She was also unable to work and function

adequately as a trainee. She requested to switch to the nursing college because she was finding her

profession to be toodemanding and was thus shifted. In the presenceof social and emotional support
from afriend, the patient was feeling better, with better interest in activities, better social and
occupational functioning.

However the friend moved to Dubai, following which she again had symptoms such as feeling sad.

crying spells, feeling lonely. feeling guilty about unable to function properly, reduced interaction
with others and the symptoms remained the same till her Completing her one-year trainee phase

Following turning down her job request atter trainin8: the patuent reached home and her symptoms
exacerbated and in addition to crying spells, feeling sad and lonely, reduced social interaction and
envelope with an address on itwhich someone had dropped, what will you do

Willsent it to post office.

DIAGNOSIS

Severe depression with psychotic symptoms

F32.3