Aggressive behaviour towards a care-giver: a case report of a patient with paranoid schizophrenia

Abstract

Background: Aggressive behaviours are often found in paranoid schizophrenia, which could occur either at the acute or chronic phases of the disorder. Paranoid schizophrenic patients may show dysfunctional impulsive aggression which may be caused by several factors such as environmental frustration. These patients have poor insight, experience disorders of thought and have poor control of their aggressive impulses.

Methods: This is a case report of a 27 year old school dropout, who has been on treatment for paranoid schizophrenia for five years. He presented with acute symptoms of the disorder which includes delusion of reference, delusion of persecution, command hallucination and restlessness. Prior to the current presentation, patient had stopped taking his medication and refused to come for follow-up. Last follow-up from records was thirteen months prior to this current admission.

Results: Clinical features met the criteria for diagnosis of paranoid schizophrenia following a relapse due to poor compliance with medication and follow-up visits.

Conclusions: Elevated risk forviolent-offending in paranoid schizophrenia is not just as a result of active symptoms, but also associated social problems. Therefore managing these groups of patients should target such issues.

Keywords: Aggressive behaviour, Care-Giver, Paranoid, Schizophrenia