INTERNSHIP REPORT

By

Nadia Ahmed Din

S22BAPSY1M04017

Department of Applied Psychology

The Islamia University of Bahawalpur

ADP 2022- 2024
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INTERNSHIP REPORT

By

Nadia Ahmed Din

S22BAPSY1M04017

Approved by

______________________

Internship Incharge

_______________________

Chairman

_______________________

External Examiner
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DECLARATION
It is hereby solemnly declared that the “Psychology Internship Report” has been done by me
and not has been presented by anyone of his/her partial fulfillment of any degree.

Nadia Ahmed Din

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CERTIFICATE
It is certified that the Internship Report has been compiled & written by Nadia Ahmed Din Roll
number S22BAPSY1M04017, student of ADP BS Applied Psychology, 8th semester,
under session 2022-2024 is hereby approved for submission. No part of this report has been
copied or reproduced somewhere else in any form nor has it been plagiarized.

Dr. Areeha Khan Durrani

Internship Incharge
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Table of Content

Case no.01

Antisocial Personality Disorder

Case no. 02

Anxiety Disorder

Case no. 03

Depression

Case no. 04

Obsessive compulsive Disorder

Case no.05

Substance Abuse Disorder

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History of Bahawalpur- Victoria Hospital, Bahawalpur

Founded on July 6, 1906 during the period of Bahawalpur Nawaz (IV), H.H. Bahawalpur Khan,
it was jointly named after him and the British Queen Victoria.

After integration of Pakistan in 1955 and merger of the defunct Bahawalpur State with the then
West Pakistan, the BVH was expanded and several wards were added to it. Later, an operation
theatre complex, comprising six well-equipped theatres, was constructed with the financial
assistance of the late Dubai Amir.

Last year, the hospital administration had drawn up a comprehensive programmer for the
centenary celebrations and formed various committees to organize doctors’ conferences and
functions. But owing to alleged political victimization of former MS Fazal Mahmood Khan,
followed by the suspension of seven doctors, the programmer fizzled out and the new
administration did not bother to arrange any function.

The clinical training of the students of Quaid-e-Azam medical college is carried out at the

Bahawalpur Victoria hospital. It started its life as a civil Hospital in 1867 with an indoor

capacity of 36 beds an outdoor department a dispensary & operation theatre. In 1906 it was

named as Bahawalpur-Victoria hospital some new buildings were constructed 40 beds were

also added & in 1997 the bed strength was 425 where today it stand at 1450.

Working nature

During patient I diagnosed patients & apply the therapies on these patients. My supervisor

helps me very much & taught me everything about internship. My supervisor also gives me

assignment daily & checks my knowledge about clinical psychology. During internship I gain

enough knowledge about clinical abnormal psychology & seeking that how I behave with

psycho patients & how I treated to them. Now I considered that I am able to treat them & solve

the psychological problems of every psycho patient.

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Case no.01:

Schizophrenia
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Summary

This case is about a patient suffering from schizophrenia. Muhammad Nadeem has been taking
marijuana filled cigarette since 1 year, so his disorder seems to be drug induce.

Introduction:

Schizophrenia is a serious mental disorder in which people interpret reality abnormally.

Schizophrenia may result in some combination of hallucinations, delusions, and extremely
disordered thinking and behavior that impairs daily functioning, and can be disabling. People
with schizophrenia require lifelong treatment.

Identifying Information:

Name: Muhammad Nadeem

Age: 21 years

Gender: Male

Education: FA

Occupation: Student

No. of Siblings: 3 (2 sisters & 1 brothers)

Birth Order: 2

Marital Status: Unmarried

Economy Status: Middle Class

Source and Reason of Referral:

Patient came to hospital with his Father. Patient came with the symptoms of schizophrenia.

Presenting Complaints:

1. Insomnia
2. Hallucinations
3. Delusion
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4. Smoking
5. Extremely Aggressive

Behavioral Observation:

Dress: Patient was wearing tidy clothes.

Eye contact: Patient was able to maintain proper eye contact.

Rate of speech: High rate of speech

History of Presenting Complaints:

Insight: Poor

Duration: Patient was experiencing hallucination and delusion from past 2 years and had been
smoking marijuana cigarettes for 1 years.

Reason of Psychological illness: Patient’s illness was maybe drug induced.

Family History:

Father: Patient’s father was alive.

Mother: Patient’s mother was died.

Siblings: Patient has 2 sisters & 1 brothers.

Personal History:

Birth: Patient’s birth was normal. At time of birth mother was very weak. His milestones were
on time.

Physical illness or injury: Not significant.

Educational History: FA

Occupational History: Patient is Student.

Psychosocial History: Patient has been taking marijuana for 1 year.

Family Psychiatry History: Not significant

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Family Medical History: Not significant

Mental State Examination:

Apparent Age: 28

Mood: Anxious

Speech: Rate: Increased

Rhythm: Articulation

Volume: Loud

Content: Fluent

Eye contact: Good

Facial Expression: Restless/Anxious/Aggressive

Attention and Concentration: Patient was able to pay proper attention.

Judgment: Poor

Social Behavior: Not good/Aggressive

Self-Care: Patient was able to take care of himself.

Hallucination: Patient was suffering from hallucination. He was feeling like he has gotten
some kind of power and he can hear such voices which other couldn’t.

Delusion: Patient was suffering from delusion.

Insight: Poor

Diagnosis:

Patient was diagnosed with Schizophrenia.

Intervention:

Tab. Serenace 0.5mg

Tab. Kempro 5mg

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Case no.02:

Depression
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Summary:

My patient, Kousar Jubeen, is suffering from depression. She is married and has four children.
She is a teacher by profession, belonging to a middle class family. She is from Multan. My
patient was in usual state of mind before encountering depression which occurred as a result of
stress caused by her husband’s second marriage.

Introduction:

Depression is a mood disorder that involves a persistent feeling of sadness and loss of interest.
It is different from the mood fluctuations that people regularly experience as a part of life.
Depression is an ongoing problem, not a passing one. It consists of episodes during which the
symptoms last for at least 2 weeks. Depression can last for several weeks, months, or years.

The symptoms of depression can include:

 a depressed mood

 reduced interest or pleasure in activities once enjoyed

 a loss of sexual desire

 unintentional weight loss or gain

 sleeping too much or too little

 agitation, restlessness, and pacing up and down

 slowed movement and speech

 fatigue or loss of energy

 feelings of worthlessness or guilt

 difficulty thinking, concentrating, or making decisions

Factors that are likely to play a role include:

 genetic features

 changes in the brain’s neurotransmitter levels

 environmental factors
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 psychological and social factors

 additional conditions, such as bipolar disorder

Types of depression

There are several forms of depression. Below are some of the most common types.

Persistent depressive disorder

Also known as dysthymia, persistent depressive disorder causes symptoms that last for at least
2 years.

A person with this disorder may have episodes of major depression as well as milder symptoms.

Psychotic depression

Some people experience psychosis with depression.

Psychosis can involve delusions, such as false beliefs and a detachment from reality. It can also
involve hallucinations — sensing things that do not exist.

Postpartum depression

After giving birth, many women experience what some people call the “baby blues.” When
hormone levels readjust after childbirth, changes in mood can result.

Major depression

A person with major depression experiences a constant state of sadness. They may lose interest
in activities that they used to enjoy.

Treatment usually involves medication and psychotherapy.

Identifying Information:

Name: Kousar Jubeen

Age: 41 years
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Gender: Female

Education: BA

Occupation: Teacher

No. of Siblings: 7 (3 sisters & 4 brothers)

Birth Order: 5

Marital Status: Married

Economy Status: Middle Class

Source and Reason of Referral:

Patient came to hospital with her brother. Patient came very sad and anxious.

Presenting Complaints:

1. Lack of sleep
2. Hopeless
3. No interest in anything
4. Restlessness
5. Fatigue
6. Anxiety
7. Weight loss

Behavioral Observation:

Dress: Patient was wearing tidy clothes.

Eye contact: Patient was not able to maintain proper eye contact.

Rate of speech: Low rate of speech

History of Presenting Complaints:

Insight: Poor

Duration: Patient was experiencing flat affect, has lost all the interests & was very anxious &
disturbed.
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Reason of Psychological illness: Patient was living happily with her husband & her children.
Problem started when her husband married to her sister who was first married to her husband’s
brother. But when patient’s sister’s husband died, patient’s husband married to her sister.

Family History:

Father: Patient’s father was Alive.

Mother: Patient’s mother was died.

Siblings: Patient has 3 sisters & 4 brothers.

Personal History:

Birth: Patient’s birth was normal. At time of birth her mother was absolutely healthy. Her
milestones were on time.

Physical illness or injury: Patient had the problem of high blood pressure.

Educational History: BA

Occupational History: Teacher

Psychosocial History: Not significant

Family Psychiatry History: Not significant

Family Medical History: Not significant

Mental State Examination:

Apparent Age: 41

Mood: Anxious/Sad

Speech: Rate: Latency

Rhythm: Monotone

Volume: Mute

Content: Paucity
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Eye contact: Poor

Facial Expression: Restless/Anxious/Sad

Attention and Concentration: Unable to pay proper attention

Judgment: Poor

Social Behavior: Not good

Self-Care: Patient was able to take care of herself.

Hallucination: Patient was not suffering from hallucination.

Delusion: Patient was not suffering from delusion.

Insight: Poor

Diagnosis:

Patient was diagnosed with Depression.

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Case no.03:

Substance use disorder

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Summary:

Kamran Farooqi, form Faqirwali belongs to a religious, middle class family. He is 30 year old
and unmarried. He was brought to doctor by his mother. He feels anxious and depressed all
day long. He has also reported aggressive behaviour. He is unable to perform any kind of task
properly due to an extreme feeling of anxiety and restlessness. At the time of giving history,
he seemed restless and was unable to sit normally.

Introduction:

Substance use disorder (SUD) among schizophrenia patients is an increasingly recognized

problem. Prevalence estimates of SUD in schizophrenia patients vary from 17% to 90%, while
the rates of DSM IV abuse or dependence range from 28.5% for nicotine, 50.8% for cannabis,
and 43.1% to 65% for alcohol . There are geographical variations of dual diagnosis prevalence
among individuals suffering from schizophrenia. For example, the US prevalence rates
highlighted that 47% of subjects with a lifetime diagnosis of schizophrenia or schizophreniform
disorder met criteria for an alcohol or a substance use disorder. Somewhat different results

Identifying Information:

Name: Kamran Farooqi

Age: 31 years

Gender: Male

Education: BA

Occupation: Self Worker

No. of Siblings: 4 (2 sisters & 2 brothers)

Birth Order: 4

Marital Status: Married

Economy Status: Middle Class

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Source and Reason of Referral:

Patient came to hospital with his mother. Patient came with the problem of drug addiction.

Presenting Complaints:

1. Loss of appetite
2. Disturbed sleep
3. Restlessness
4. Harmful to others & himself

Behavioral Observation:

Dress: Patient was wearing tidy clothes.

Eye contact: Patient was not able to maintain proper eye contact.

Rate of speech: Low rate of speech

History of Presenting Complaints:

Insight: poor

Duration: Patient was suffering from substance abuse disorder for 1 year

Reason of Psychological illness: A possible reason for patient’s illness was of course his
addiction to drugs.

Family History:

Father: Patient’s father was alive.

Mother: Patient’s mother was alive.

Siblings: Patient has 2 sisters & 2 brothers.

Personal History:

Birth: Patient’s birth was normal.

Physical illness or injury: Not significant.

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Educational History: BA

Occupational History: Shopkeeper

Psychosocial History: Not significant.

Family Psychiatry History: Not significant

Family Medical History: Not significant

Mental State Examination:

Apparent Age: 30

Mood: Anxious

Speech: Increased

Eye contact: Good

Facial Expression: Anxious/Aggressive

Attention and Concentration: Patient was able to pay proper attention.

Judgment: Poor

Social Behavior: Not good/Aggressive

Self-Care: Patient was able to take care of himself.

Hallucination: Patient was not suffering from hallucination.

Delusion: Patient was not suffering from delusion.

Insight: Poor

Diagnosis:

Patient was diagnosed with substance use disorder.

Intervention:

Piriton(4mg)
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Diclo(50mg)

Valiem(5mg)
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Case no.04:

Obsessive Compulsive Disorder

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Summary:

Maham Iqbal , form Arif wala belongs to a religious, lower class family. She is 25 year old
and unmarried. She was brought to doctor by her elder brother. She feel restlessness. She also
reported having negative thought problem.

Introduction:

Obsessive–Compulsive Disorder (OCD) is a serious anxiety-related condition that affects 1.2%

of the population, which is around three quarters of a million people here in the UK based on
current estimates. Together with their families, who support people with OCD, and are
frequently involved in their rituals, this means Obsessive–Compulsive Disorder is a part of
daily life for over 1 million people every single day.

Obsessive-Compulsive Disorder (or more routinely referred to as OCD) is a serious anxiety-

related condition where a person experiences frequent intrusive and unwelcome obsessional
thoughts, commonly referred to as obsessions. Obsessions are very distressing and result in a
person carrying out repetitive behaviors or rituals in order to prevent a perceived harm and/or
worry that preceding obsessions have focused their attention on. Such behavior include.

If you feel you might be affected by Obsessive-Compulsive Disorder you can find out about
how OCD is diagnosed elsewhere in this chapter. Below you can read more about the illness
and aspects of living with OCD.

Identifying Information:

Name: Maham Iqbal

Age: 25 years

Gender: Female

Education: BA

Occupation: Student

No. of Siblings: 3(1 sister & 2 brothers)

Birth Order: 3rd

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Marital Status: Unmarried

Economy Status: Lower Class

Source and Reason of Referral:

Patient came to hospital with his elder brother. Patient came with the symptoms of Obsessive
compulsive disorder.

Presenting Complaints:

1. Repetitively washing hands

2. Negative thoughts
3. Restlessness
4. Fearful

Behavioral Observation:

Dress: Patient was wearing tidy clothes.

Eye contact: Patient was able to maintain proper eye contact.

Rate of speech: Low rate of speech

History of Presenting Complaints:

Insight: Poor

Duration: Patient was experiencing anxiety, was obsessed with washing hands & was
experiencing negative thoughts for 5 years.

Reason of Psychological illness: Patient was obsessed with clean hands since childhood due
to harsh toilet training.

Family History:

Father: Patient’s father was died.

Mother: Patient’s mother was died.

Siblings: Patient was only 2 brothers & has 1 sister.

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Personal History:

Birth: Patient’s birth was normal. At time of birth her mother was absolutely healthy. Her
milestones were on time.

Physical illness or injury: Not significant

Educational History: BA

Occupational History: Student

Psychosocial History: Not significant

Family Psychiatry History: Not significant

Family Medical History: Not significant

Mental State Examination:

Apparent Age: 20

Mood: Anxious/Restless

Speech: Increased

Eye contact: Good

Facial Expression: Restless/Anxious

Attention and Concentration: Patient was able to pay proper attention

Judgment: Good

Social Behavior: Normal

Self-Care: Patient was able to take care of himself.

Hallucination: Patient was not suffering from hallucination.

Delusion: Patient was not suffering from delusion.

Insight: Fair
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Diagnosis:

Patient was diagnosed with Obsessive Compulsive Disorder.

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Case no.05:

Conversion Disorder
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Summary:

The patient Hamza Iqbal suffering from conversion disorder, is ten years old. Patient is
experiencing seizures, fits, problematic breath and lack of sleep. Patient belonging to a religious
lower class family lives in Khan Bela. A possible reasons for patient’s illness is sudden death
of his elder sister. He was very attached to his sister who died four months ago.

Introduction:

Conversion disorder, also called functional neurological symptoms disorder, is defined as a

psychiatric illness in which symptoms and signs affecting voluntary motor or sensory function
cannot be explained by neurological or general medical conditions. Conversion disorder is a
condition in which you have physical symptoms of a health problem but no injury or illness to
explain them.

Physical symptoms can sometimes help with an internal conflict. Conversion disorder symptoms
usually come on suddenly and look like problems with your nervous system (brain, spinal cord, or
other nerves). They include:

 Movements that you can’t control

 Tunnel vision or blindness
 Loss of smell or speech
 Numbness or paralysis

Identifying Information:

Name: Hamza Iqbal

Age: 18 years

Gender: Male

Education: FSC

Occupation: Student

No. of Siblings: 6 (3 sisters & 3 brothers)

Birth Order: 5
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Marital Status: Unmarried

Economy Status: Lower Class

Source and Reason of Referral:

Patient came to hospital with her mother. Patient was attached to her elder sister who died 4
months ago.

Presenting Complaints:

1. Lack of sleep
2. Lack of hunger
3. Headache
4. Seizures/Fits
5. Breathing problem

Behavioral Observation:

Dress: Patient was wearing tidy clothes.

Eye contact: Patient was not able to maintain proper eye contact.

Rate of speech: Low rate of speech

History of Presenting Complaints:

Insight: Poor

Duration: Patient was experiencing symptoms of conversion disorder for previous 3 months.

Reason of Psychological illness: A possible reason for patient’s illness was his sister’s
death whom she was very close to.

Family History:

Father: Patient’s father was alive.

Mother: Patient’s mother was alive.

Siblings: Patient has 3 sisters & 3 brothers.

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Personal History:

Birth: Patient’s birth was normal. At time of birth her mother was absolutely healthy. Her
milestones were on time.

Physical illness or injury: Not significant

Educational History: Not significant

Occupational History: Not significant

Psychosocial History: Not significant

Family Psychiatry History: Not significant

Family Medical History: Not significant

Mental State Examination:

Apparent Age: 22

Mood: Sad

Speech: Rate: Normal

Volume: Soft

Content: Impoverished

Eye contact: Poor

Facial Expression: Sad/Anxious

Attention and Concentration: Unable to pay proper attention

Judgment: Poor

Social Behavior: Good

Self-Care: Patient was able to take care of himself.

Hallucination: Patient was not suffering from hallucination.

Delusion: Patient was not suffering from delusion.

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Insight: Poor

Diagnosis:

Patient was diagnosed with Conversion Disorder.

Intervention:

Behavioral Therapy

Cognitive Behavior Therapy

Rational Emotive Therapy