Mental Health

Schizophrenia Case Study: Real-Life Examples of Diagnosis, Symptoms, and Treatment

Written By

Jagruti Rehab

Last Updated on: 20 May 2025

Schizophrenia is a persistent psychiatric disorder that changes a person's perception of reality, such as hallucinations, delusions, poor thinking, and emotional dysregulation. Schizophrenia affects daily life and quality of life.

In this detailed schizophrenia case study, we take a real-life example of how early symptoms arise, how one becomes diagnosed, and what treatment procedures are undertaken for successful recovery. You will understand how schizophrenia can be diagnosed and successfully treated with proper interventions, emotional counselling, and regular care.

Patient Information

• Age: 24
• Gender: Male
• Location: Pune, India

Background: Rahul (whose name has been changed) was a recent engineering graduate from Pune, India. He belonged to a well-educated middle-class family. Rahul had a background of academic success and incisive analytical abilities.

History or Cause

Rahul was a brilliant and ambitious young boy preparing for competitive government exams after graduation. He was often praised by his parents and teachers for his logical mind and diligence.

But there were certain behavioural changes in him that had been extremely subtle during his examination preparation time. He started withdrawing from family and friends, continued to avoid social contact, and became suspicious. Rahul was certain that certain unknown people were trailing him. He was convinced the mobile number was tapped and was overheard talking to himself several times.

After a few months, the symptoms got worse. He no longer slept well, became paranoid, and now exhibited extreme anxiety and confusion. Eventually, during one of his psychotic attacks, he attacked family members over suspected spying and was hospitalised. The family subsequently uncovered a history of mental illness, with Rahul's maternal uncle having been treated for schizophrenia years earlier. Genetic predisposition, chronic stress, and the need to do well in school all contributed to unleashing his illness.

Diagnosis

Rahul was sent to a Jagruti psychiatric rehabilitation centre for a comprehensive evaluation. 

Diagnosing him involved a long process with multiple steps:

1. Clinical Interview

An accredited psychiatrist assessed Rahul several times. He presented persecutory delusions, auditory hallucinations, and flattening of affect. Rahul perceived that others were plotting against him and often complained about hearing voices informing him about danger.

2. Mental Status Examination (MSE)

The important observations were:

• No eye contact
• Reduced emotional display
• Slow and flat speech
• Disorganised and tangential thought

3. Diagnostic Tools and Criteria

Routine diagnostic tools and criteria were used for accurate diagnosis:

• DSM-5 criteria for Schizophrenia
• PANSS (Positive and Negative Syndrome Scale) to assess the severity of symptoms

Rahul was diagnosed with Paranoid Schizophrenia. A disorder with hallucinations and delusions, but with fairly intact cognitive and emotional functioning.

Treatment

At Jagruti Rehab in Hyderabad, the treatment plan was developed by psychiatrists, psychologists, occupational therapists, and the patient's relatives. The treatment plan included medical stabilisation, therapy, social rehabilitation, and long-term management.

Initial Hospitalisation (Week 1–2)

Rahul was admitted to a psychiatric ward to stabilise acute psychotic symptoms. The prescribed medications were:

• Risperidone (2–4 mg/day)
• Minimal anxiolytics for restlessness and paranoia

Medication Monitoring

Drowsiness and weight gain side effects were carefully monitored. Baseline liver function tests and blood pressure were checked regularly.

Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy began in Week 3, with the following objectives:

• Identification of delusional thinking and challenging the same
• Development of reality-testing skills
• Gaining emotional regulation and mindfulness skills

Group Therapy

Rahul had bi-weekly group therapy, which helped:

• In building social confidence
• Promoting peer support
• Reducing the isolation and stigma of mental illness

Family Psychoeducation

His family attended workshops to:

• Better understand schizophrenia
• Recognise the warning signs of relapse
• Learn how to support Rahul without reinforcing delusions

Occupational Therapy and Routine Structuring

Rahul was given easy tasks like:

• Sorting books
• Solving jigsaw puzzles
• Keeping a daily planner

These helped him build a routine and get his concentration back.

Recovery Timeline and Improvements

Weeks 1–2: Stabilisation Stage

• Hallucinations and delusions reduced
• Sleep patterns improved
• Rahul became more responsive and was calm

Week 3–4: Therapy Integration

• CBT sessions began with cognitive exercises
• Rahul showed enhanced concentration
• The first signs of self-awareness of his illness were noticed

Weeks 5–8: Social Development

• Group therapy improved confidence
• Re-engaged with online technical blogs and courses
• Reduction in delusional thoughts and frequency

Weeks 9–12: Reintegration and Future Planning

• Supervised weekend home visits began
• Rahul enrolled in an online data science course
• Volunteered to guide newcomers at the rehab centre

Achievement and Impact On Rahul’s Life

After three months of supervised treatment, Rahul began showing dramatic improvements. He began a blog on his experience to enlighten the youth. He goes on:

• On a low-maintenance dose of medication
• Bi-weekly therapist sessions
• Semi-independent living with career plans in the IT sector

Family and Community Transformation

Rahul's parents turned into mental health advocates. They became members of a NAMI-affiliated support group and informed other families about the need for early intervention and stigma resistance.

Next Steps for Rahul

• Current Outpatient Therapy: Bi-monthly psychiatrist and CBT sessions
• Peer Support: Ongoing attendance at schizophrenia peer groups
• Vocational Training: To acquire industry-level technical skills
• Mindfulness and Meditation: As part of the daily routine for well-being
• Family Support Circles: For frequent emotional check-ins

What We Learned from This Schizophrenia Case Study

1. Early Symptoms Should Be Taken Seriously

Social withdrawal, paranoia, and irrational fears can be indicators of early-onset schizophrenia, not stress.

2. Family Support is Crucial

Involved and educated families help speed recovery and reduce relapse risk.

3. Complete Treatment Makes the Difference

Medication alone is insufficient. Therapy, daily routines, and emotional support are essential.

4. Recovery Is Possible

With a proper treatment plan and determination, schizophrenic patients can lead normal lives.

5. Stigma Against Mental Illness Must Stop

Awareness can translate into early diagnosis, faster recovery, and increased social acceptance.

Bottom Line

Schizophrenia is not an end in itself. Rahul's case is proof that with timely intervention, structured care, and compassionate support, recovery becomes possible. This case study is a story of hope, resilience, and community strength.

Author

Jagruti Rehabilitation Centre is a leading facility specializing in mental health, dementia, and addiction recovery. The team of psychiatrists, psychologists, and caregivers is committed to empowering individuals on their journey to recovery.