African American Female with a History of Paranoid Schizophrenia

African American Female with a History of Paranoid Schizophrenia Comprehensive Psychiatric Evaluation Template
With Psychotherapy Note
Encounter date: _Friday 22nd July 2022_______________________
Patient Initials: _M.T_____ Gender: M/F/Transgender _Female___ Age: _67 years____ Race: _African American____ Ethnicity _Haitian___
Reason for Seeking Health Care: Mrs. Taylor is a 67-year-old African American female with a history of paranoid schizophrenia. She is accompanied by her daughter Mary (35 years old) who asserts that the patient started showing signs of a relapse three weeks ago. The patient states that “I have to go back and stop those murderous, thieving neighbors from sacrificing my grandchildren”.
HPI: Mrs. Taylor was diagnosed with paranoid schizophrenia 49 years ago after her first pregnancy. She received treatment for the mental disorder and has been doing quite well, although even with a good response to initial treatment, her symptoms habitually return. Her most recent relapse was seventeen years ago and her daughter claims that there was another relapse preceding the last one. The first relapse happened after the death of her eldest son, who died in a car accident after driving under influence. Her daughter reports that “the death of my elder brother was a shock to us all. He was doing very well for himself and we did not know of his tragic alcohol addiction. My mother was most affected and the extreme life event saw her lose interest in everything and become increasingly irritable. We thought she was just devastated and didn’t notice the early symptoms of her relapse until she started screaming in her sleep that the death of my brother was no accident but a design by our neighbors to reduce the family to poverty. My brother was a bright man. He was the first in our community to go to college. He got a job as an engineer at a leading software firm and was generous with his salary. He had even promised to buy my mother a house in a better neighborhood. My mother immigrated from Haiti as a teenager and continues to hold very strong Voodoo beliefs about the evil eye and human sacrifice disguised as accidents”. Mrs. Taylor was re-admitted and promptly re-introduced to antipsychotic treatment. She managed to regain control of her symptoms and even opened up a grocery store, which she run with her surviving daughter-in-law. Her daughter states that “I believe that being busy at the store was a good thing for my mother. In addition to supporting our family, the constant interaction with family and friends played an important role in her treatment and recovery. She was coping very well with the death of her son and succeeding at building a rich, meaningful life”. Unfortunately, her progress was cut short by a burglary incident where two robbers fired gunshots after entering the grocery store and demanded that Mrs. Taylor (who was at the cash register) hand over everything. Her daughter recalls that “one of the robbers pistol-whipped my mother twice for ‘holding out’. She was rushed to hospital and got seven staples for the head injury”. Mrs. Taylor refused to leave the house after that incident and had difficulty concentrating. Unfortunately, her dis...