Dr.How to handle with agression and violent behaviour, depression is cause or something else ?.

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There can be multiple differential diagnosis for aggression and violent behavior like 1) Adjustement disorder with problems of emtion and conduct if acute stressor is present as in ur case lockdown and when insight is present. 2) Acute and transient psychotic disorder, if acute stressor and other associated psychotic symptoms like delusions, hallucinations, absent insight. Possible in ur case if absent insight. 3) Depressive disorder, can have irritability and agression 4) Manic episode/ Bipolar disorder if aggression and violence is associated with absent insight 4) Schizophrenia 5) Impulse control disorder like intermittent explosive disorder 6) Personality disorder- borderline and antisocial 7) Substance use disorder under intoxication and withdrawal 8) episodic non goal directed aggression can be manifestation of epilepsy ( CPS) 9) Neurological condition like brain malignancy Management depends on accurate diagnosis. But in emergency its a step wise approach- 1) Verbal restraint- try to talk, establish rapport and reassure 2) if verbal restraint nt successful Chemical restraint- iv lorazepam 4mg alone/ iv haloperidol 5mg serenace+ inj phenergan 25 mg / iv haloperidol 5mg+ lorazepam 4mg 3)Physical retraint- if verbal and chemical both ineffective.
Actually Doctor patient is saying to me that he got anger very soon he is not able tolerate a single pinch or comment,some time he becomes aressive on family members on small things of general routine...He is facing business loss and financial crisis due to lockdowns...
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Respected Dr Khan aggresive and violent behaviour is an expression of sone mental pathology, be it a personality disorder or other due to overstimulation of amygdala and related neucluses. One should not jump to lebel one disease. I consider to switch over to pharmacological treatment by perenteral shot of either haloperidol or one benzodiazepin to let the calm first. After that detailed history taking and next course is to be determined.
Actually sir patient is saying to me that he got anger very soon he is not able tolerate a single pinch or comment,some time he becomes aressive on family members on small things of general routine...He is facing business loss and financial crisis due to lockdowns...
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Schizophrenia. No argument with pt or attendants. Reassurance and counciling required. Inj clobozam iv given stat slowly strictly under supervision and handle carefully to avoid any eventually. Psychiatrist opinion and help must .
Thanks Dr Shivraj Agarwal
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Aggression and violent behaviour of a person suggest pt is shizophrenic and urgently need psychiatrist help Iv tranquillisers like inj clobozam and anatensol are to be given under his supervision. Followed by oral treatment
Thanx dr Pushkar ji Bhomia
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May be brief psychotic disorder. Schizophreniform disorder Schizophrenia. Schizotypal Bipolar one disorder manic episode ir depresive episode. Do IV DIAZEPAM 5M Then proceed with antipsychotic medications.
I disagree with most of the senior doctors recommending for iv haloperidol or benzodiazepine. My advice would be take detailed history give him etizolam evaluate and then proceed. consider radio imaging also
Refer the patient to the Psychiatrist for proper history taking & MSE, without doing unnecessary treatment. Correct Diagnosis is the must for any psychotherapeutic medications.
Mostly it is psychotic behavior of whatever csuse. Pl give im/iv haloperidol ,(,serenace) .agression is vontrolled in half an hour.then youcan work on case
Actually sir patient is saying to me that he got anger very soon he is not able tolerate a single pinch or comment,some time he becomes aressive on family members on small things of general routine...He is facing business loss and financial crisis due to lockdowns...
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SUGGESTIVE of SCHIZOPHRENIA.. NEEDS. FURTHER. EVALUATION
Case of Schizophrenia refer to psychiatrist
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