ABSTRACT | PDF

Case Report I

Regression towards childhood

Ajit Kumar Kakati
Postgraduate Trainee of Psychiatry
Silchar Medical College and Hospital

A 27 years old Islam female was brought with increased symptoms of talking and laughing at self, occasional aggressiveness and giggling at people without reason for eight months.

After passing class XI 11 years back, she started looking at the mirror at home and started giggling. When parents asked about the reason, she never replied. She also started complaining that male friends often teased at school and school teacher wanted to love her. Parents on enquiry found no guilt of her teacher. Rather she didn’t show any regards to teachers and seniors. She often quarreled with friends at school. She had three to four Hindu friends with whom she started visiting temples. She developed liking to dress like Hindu females. She used to do things according to her likings. If someone objected, she became fretful.  After failing in class XI examination, she started pressurising father to engage her in a music school as she was a graduate in classical vocal songs. Knowing her behaviour, father tried to console her that no vacant post was available in the school. She then gradually started avoiding family members and started to sing sa-re-ga-ma, while remaining aloof. She would cry and laugh at self and remain awake in the night. At time she became aggressive and hit mother telling about job. She was treated by a psychiatrist for three months and then they stopped medication due to excessive sleep. After six months, she was again treated by another psychiatrist and continued treatment for two years and nine months. Her symptoms like occasionally laughing at self and talking ‘out of context’ didn’t completely subside. She also started hearing voice of a small boy who sometimes started belittling her. After two months’ discontinuation of medication, she was treated as indoor patient but complete recovery could not be seen. Two years later, she became nonadherent to treatment.

Five years back, she attempted suicide by taking a handful of tablets. At that time she was treated by a neurologist and her treatment continued for two years only by parenteral route. Three years back, she was married but her treatment continued for 12 more months under the guidance of her in-laws. When she became pregnant, medicines were stopped and she was then treated by a faith healer. She delivered a baby and four months later, her symptoms started aggravating.

On mental status examination, well groomed, endomorphic built, hygiene maintained, poor eye to eye contact, stereotype gestures, increased psychomotor activity at time, conscious, cooperative, comprehensive, speech was monotonous, low in flow, irrelevant at times, euthymic mood, inappropriate affect, shallow intensity, lability, loosening of association and level one insight.

She was provisionally diagnosed as a patient of hebephrenic schizophrenia, continuus (F20.10).

 

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