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A Case of Bipolar Affective
Disorder r/o Paranoid
Schizophrenia
_______________
A Psychiatric Case Study
Presented to the
Faculty of the College of Nursing
Colegio San Agustin Bacolod
_______________
In Partial Fulfillment of
the Requirements for
the course Nursing Care Management 203
_______________
By:
Chiara Francesca L. Miranda
BSN3-B/Group 7
June 2010

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COLEGIO SAN AGUSTIN-BACOLOD
College of Nursing
PSYCHIATRIC NURSING CASE ANALYSIS RECORD (PNCAR)-INITIAL
INTRODUCTION (Narrative overview of patient’s diagnosis based on book view)
Bipolar disorders are those in which individuals experience the extremes of
mood polarity. Individuals might feel very euphoric or very depressed. Although the
term bipolar disorder is accepted diagnostic terminology, many professionals and much
professional literature still use the terms manic-depressive or bipolar affective disorder
(Keltner, Psychiatric Nursing 5
th
Edition, p. 393).
Predisposing and precipitating factors of Bipolar Affective Disorder includes
genetic wherein First-degree relatives of people with BPI are approximately 7 times
more likely to develop BPI than the general population. Remarkably, offspring of a
parent with bipolar disorder have a 50% chance of having another major psychiatric
disorder (Soreff & McInnes, 2006). Moreover, according to Soreff (2006), Multiple
biochemical pathways likely contribute to bipolar disorder, which is why detecting one
particular abnormality is difficult. A number of neurotransmitters have been linked to
this disorder, largely based on patients' responses to psychoactive agents.
Environmentally, Because of the nature of their work, certain individuals have periods
of high demands followed by periods of few requirements. For example, one person
was a landscaper and gardener. In the spring, summer, and fall, he was busy. During
the winter, he was relatively inactive except for plowing snow. Thus, he appeared
manic for a good part of the year, and then he would crash and hibernate for the cold
months.
Schizophrenia, on the other hand, is a diagnostic term used to describe a major
psychotic disorder characterized by disturbances in perception, thought process, reality
testing, feeling, behaviour, attention, motivation. Contributing to the overall
deterioration is a decline in psychosocial functioning (Keltner, Psychiatric Nursing 5
th
Edition, p. 339).
The most common type of schizophrenia is Paranoid Schizophrenia. The
clinical picture is dominated by relatively stable, often paranoid, delusions, usually
accompanied by hallucinations, particularly of the auditory variety, and perceptual
disturbances. Disturbances of affect, volition, and speech, and catatonic symptoms, are
not prominent.
Examples of the most common paranoid symptoms are delusions of
persecution, reference, exalted birth, special mission, bodily change, or jealousy;
hallucinatory voices that threaten the patient or give commands, or auditory
hallucinations without verbal form, such as whistling, humming, or laughing;
hallucinations of smell or taste, or of sexual or other bodily sensations; visual
hallucinations may occur but are rarely predominant.
The course of paranoid schizophrenia may be episodic, with partial or complete
remissions, or chronic. In chronic cases, the florid symptoms persist over years and it is
difficult to distinguish discrete episodes. The onset tends to be later than in the
hebephrenic and catatonic forms (WHO, ICD-10, 1992).

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     A Case of Bipolar Affective Disorder r/o Paranoid Schizophrenia       _______________         A Psychiatric Case Study Presented to the Faculty of the College of Nursing Colegio San Agustin – Bacolod       _______________       In Partial Fulfillment of the Requirements for the course Nursing Care Management 203       ­­­­ _______________       By:    Chiara Francesca L. Miranda BSN3-B/Group 7 June 2010 COLEGIO SAN AGUSTIN-BACOLOD College of Nursing PSYCHIATRIC NURSING CASE ANALYSIS RECORD (PNCAR)-INITIAL INTRODUCTION (Narrative overview of patient’s diagnosis based on book view) Bipolar disorders are those in which individuals experience the extremes of mood polarity. Individuals might feel very euphoric or very depressed. Although the term bipolar disorder is accepted diagnostic terminology, many professionals and much professional literature still use the terms manic-depressive or bipolar affective disorder (Keltner, Psychiatric Nursing 5th Edition, p. 393). Predisposing and precipitating factors of Bipolar Affective Disorder includes genetic wherein First-degree relatives of people with BPI are approximately 7 times more likely to ...
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