Official Diagnosis = Dementia Praecox

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State of New York -- Department of Mental Hygiene

Rockland State Hospital

October 18, 1932

We have a psychosis in a young man of 34 with a fairly typical pre-psychotic schizoid personality who has shirked his responsibility in supporting his family during the past four years. In spite of several jail sentences for non-support of his family this did not seem to have any marked effect upon him. For no sooner was he taken out than he would slump back again to his old ways, remaining at home and refusing to work. As a result, a number of arguments ensued between the patient and his wife which finally wound up in a fight -- the patient striking or beating her. As time went on, he developed paranoid delusions that his wife was in league with the landlord, as well as the fact that she attempted to poison him. 

He attempted to assert his authority in the home by insisting that he was boss, becoming excited and quarreling and which ended in beating her up. During the past year he has shown memory defects, and has been forgetful. Prior to his admission to Bellevue 6 months ago he became sexually impotent and developed ideas of infidelity against his wife.

Since his admission he has shown very little improvement, maintaining his impulsiveness, hyperactivity, and elated mood. At times his conversation is rambling and somewhat disjointed. He expresses the idea that it is foolish for his wife to come see him, and it is better for her to be with the children. He feels that she has no business here.

He still expressed ideas of infidelity and paranoid trends directed against her. There is no evidence of hallucinations, either auditory or visual. His physical condition is good. He helps with the ward routine, although at times it is necessary to coax him to have orders carried out.

Diagnosis: Dementia Praecox, Paranoid type

Condition: Unimproved

Prognosis: Guarded

Treatment: Institutional care, occupational and social therapy

Dr. A.M. Stanley

Clinical Director