Case History – Training Record

Training-only case history. For educational and supervision purposes.

Created: 03 Jun 2026, 19:29

Student & Batch

Student: Drashti

Batch: Dec25

Case Header & Socio-demographic Details

Client name: Mr. Ramesh

Age: 65 years

Gender: Male

Marital status: xyz

Education: xyz

Occupation: xyz

Residence: xyz

Religion: xyz

Socio-economic status: Middle

Handedness: xyz

Identification marks: no

Disability / Medical issues: no

Referral & Presenting Complaints

Source of referral: Self

Relationship with informant: none

Chief complaints:

1. Hear voices as soon as he is going or asleep 2. Because of which he cant sleep, resulting in tiredness

Presenting concerns:

The old man all living by himself is unable to sleep properly because he keeps hearing the voices and is tired in need of desperate help. He did not report that anyone is controlling him or putting thoughts in his mind.

Client verbatim statement:

“Doctor, at night, just before I fall asleep, I hear people abusing me. Because of that my sleep gets disturbed.” “I’m tired, I just want to sleep.”

History of Present Illness (HOPI)

A – Affect / Emotion

Seemed genuinely distressed, not angry or suspicious toward the clinician. Appeared anxious and fatigued

B – Behaviour

mild shakiness in his hands, worried, tired look, he looked tense and sleep-deprived. His speech was normal in rate and tone

C – Cognition

He was oriented to time, place, and person, but his attention seemed a little reduced, likely due to poor sleep. When you asked what he thinks is happening, he admitted he is not sure, but he knows it is not normal and wants help, showing limited-to-fair insight.

D – Daily functioning

Sleep was major factor which was affected very badly.

Onset & Course

Onset details

Considering the possible medical or neurological factors and medication side effects it can be said that experience sleep-onset auditory phenomena (hypnagogic experiences)

Course details

Continuous

5 P's – Case Formulation

Predisposing factors

Possible medical or neurological factors

Precipitating factors

Medication side effects

Perpetuating factors

None

Protective factors

None

Present maintaining factors

Possible medication side effects

Extended History

Family history

xyz

Personal history

xyz

Educational history

xyz

Vocational / occupational history

xyz

Sexual and marital history

xyz

Forensic history

xyz

Suicidal / self-harm / substance use history

No self harm and willingness to get out of the situation

Living conditions

Alone

Premorbid personality

Neatly dressed and polite in his manner of speaking, oriented to time, place, and person

SMART Goal Plan

1. basic sleep hygiene 2. stimulus control: keep a regular sleep-wake schedule, 3. avoid long daytime naps, 4. reduce caffeine late in the day 5 .avoid lying awake in bed for long periods. 6. simple bedtime relaxation routine like slow breathing and muscle relaxation. 7. suggested bringing a caregiver or family member next time for collateral history, and advised monitoring for daytime symptoms or decline in functioning.

Summary & Additional Notes

Summary: (not filled)

(no extra notes)