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Schizophrenia simplex: The patient will show all clinical findings described above, but the symptoms that help in diagnosing the type are by observing his/her reactions to happenings of great importance as if they are not concerned with him/her.
Hebephrenic schizophrenia: The patient is very much disorganized by hallucinations, illusions, and delusions, etc., that he or she may become impulsive and commit crimes.
Paranoid schizophrenia: In this type, the patient will retain much of the original personality but will suffer from distortion of thought with persecutory or grandiose delusions and hallucinations to such an extent that he/she will pose a distorted view of the world around.
Catatonic schizophrenia: In this type, patients will have mood disorders characterized by rigidity stupor, agitation, bizarre posturing, and repetitive imitation of movements or speech of other people. They are at risk of malnutrition, exhaustion, and self-injury.
Undifferentiated schizophrenia: In this type, the patient will have characteristic positive and negative symptoms of schizoma but do not meet the specific criteria of other subtypes.
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Preliminary Particulars
Presenting Complaints: Record the presenting complaints with particular reference to onset of present illness, duration, course, precipitating, aggravating, maintaining or relieving factors, etc.
History of Present Illness
Past History
Family History: History of chorea, epilepsy or frank mental illness, etc, may be found among the parents or siblings of the patients, as most of the mental illnesses are hereditary in origin, seen in members of the same family.
Personal History
Physical Examination: Patient can present with deformities in the head or body, careless dressing style, abnormal walking manners, furred tongue, dry skin, moist palms and soles, rapid pulse, abnormally high body temperature, etc.
Examination of Mental Status/Conditions
Investigations
Diagnostic Formulation
Certification
A certification of a mentally ill by a doctor on single examination is not correct. Recommendations in issuing certificate for mental illnesses are as follows:
Conduct three consecutive examinations on three occasions.
Describe the actual clinical picture in the certificate.
Give clear-cut reasons of diagnosis made.
Rule out the possibilities of feigned insanity.
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Voluntary or Direct Restraint: Here the mentally unsound person submits a written application directly to the officer in-charge of the hospital for admission and treatment.
Reception Order on Petition: Here the insane is admitted to the mental hospital only if the following formalities are fulfilled:
Reception Order other than on Petition
Reception after Judicial Inquisition: If a person possessing huge property turns mentally ill, the high court or district court may pass an order of inquisition and arrange for:
Reception of Mentally Ill Criminal: It is one who is mentally ill and has committed a crime or become mentally ill after being imprisoned. For such a patient’s reception presiding officer of the court issues order.
Reception of the Escaped Mentally Ill: Such a patient can be readmitted to mental hospital by a police officer or any officer or servant of the hospital.
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Civil Responsibilities
Criminal Responsibilities
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