engleski

SUICIDALITY IN SCHIZOPHRENIA PATIENT: A CASE REPORT

Introduction/Objectives: Schizophrenia is a chronic psychiatric disorder with a heterogeneous genetic and neurobiological background it is expressed as a combination of psychotic symptoms and cognitive dysfunctions. It`s prevalence in general population is about 1%. Symptoms of schizophrenia are categorised as positive (delusions, hallucinations and disorganized speech), negative (social with¬drawal, affective flattening, anhedonia) and cognitive. On average, patients with schizophrenia have a shorter life than the general population. Suicide is considered the main reason for shorter life in younger schizophrenia patients while cardiovascular comorbidities are main contributors in later years. Antipsychotics can relieve psychotic symptoms, but do not lead to significant improvements in social and cognitive functioning. Case report: We present a case of a 53-year old patient diagnosed with schizophrenia. The patient was hospitalised at the Clinic for Psychiatry multiple time, because of several suicide attempts. She attempted suicide in different wais, she took several pills of valproate, twice she tried to cut her throat and once she cut both of her wrists. Complete blood test results were normal, except total cholesterol (6, 24mmol/l) and LDL cholesterol (4, 26 mmol/l) which were elevated. EEG and CT scan were normal. Physically, the patient has hypertension. In therapy she takes valproate, alprasolam, risperidon, zolpidem, biperiden and intramuscular depo application of paliperidon. Before each suicide attempt the patient had severe exacerbation of negative symptoms (imperative auditory hallucination, negative thoughts such as worthless). During hospitalization the patient was included in sociotherapy programme and her pharmacological treatment was modified. Conclusions: Schizophrenia is on of the most serious psychiatric diagnoses. The patients have shorter life because of suicide in the earlier age. Antipsychotics can relive symptoms, but they will not significantly improve cognitive and social functioning and that is the reason why all patients with schizophrenia should be included in sociotherapy programmes. We presented this case report to show how devastating suicide attempts can be and how deeply they can torture a patient. After each treatment modification and sociotherapy programme the patient was stabilised and distant from suicidal thoughts.

suicidality ; schizophrenia

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