Admission Details for Patient: A Y W (9448)
Gender: Female Age: 50
Marital Status: Married Religion: Church of England
Occupation: None recorded
Address: Barmouth (admitted from Police Station), Merionethshire
Date of Admission: May 30, 1920
Date of Discharge: September 20, 1920
Discharge Category: Recovered
Disease: Mania
Supposed Cause: Heredity/Previous insanity
Medical Certificate:
Wild expression. Very excited. Incoherent speech and very talkative. Has hallucinations. Charging people with being drunk etc.
Not been sleeping well for last 3 weeks. Buying unnecessary things for household and very extravagant and destructive. Inclined to wander (by husband J W).
Dr. John Owen Williams, Barmouth, 30th May 1920.
Approximate duration of present attack: 3 weeks
Number of Previous Attacks: 4
Number of Previous Admissions: 3
Number of Subsequent Admissions: 3
Total Number of Admissions: 7
Relatives affected: Mother and sister
Number of Previous Attacks: 4
Epileptic: No
Suicidal: No
Dangerous: No
Clean Habit:
Food Refusal:
Sleep Habit:
Destructive Habit:
Disposition:
Education:
Physical/Mental State at Examination: Good health and condition. Noisy, talkative and restless. Conversation rambling. Constantly bursting out into peals of laughter.
(A Y W's mother was a patient at Denbigh from 1904 to 1906 when she was thought well enough to be cared for at home and discharged 'relieved'. An older sister, E Y, became insane for the first time in 1876 when A Y W was just 6 years old. The sisters were both admitted to the asylum within a few months of each other in 1907 but while A Y W was discharged recovered 3 months later, E Y remained a patient and died in the asylum in 1913).
Current Diagnosis: Bipolar disorder (F31.1)
Case Notes
1920 June 2 (copy) - Suffering from Mania. Excited and talkative. Talks a lot of nonsense.
On admission very noisy and restless but has now quietened down somewhat.
10 to 18 - No change.
25 - Has improved mentally and able to employ herself. July 1 - Improving slowly. Aug 1 - Has improved during last month and regularly employed. Aug 20 - Discharged on trial.
Medications/Treatments:
Additional Notes
Previous admissions:
11th February 1892 (No. 4416) with a diagnosis of Mania suggested to have been caused by Influenza. The Medical Certificate reads: I. Most incoherent in her conversation and relating most fanciful stores as facts which, on enquiry from her friends, were utterly groundless. Suffering from headache and seeing imaginary objects. II. Facts communicated by Mrs M. J. Powell, Workhouse Matron. Tearing her clothes into shreds, attempting to escape by opening the window at night. Locking herself in a room and refusing anyone to be admitted.
She was discharged recovered on 29th April 1892.
9th August 1907 (No. 6975) with Sub Acute Mania.
The Medical Certificate reads:
I. Incessant incoherent rambling talk.
She is very restless and sleepless, has various delusions.
When thwarted she becomes very excitable using most violent and insulting language. II.
Mr. W Y, her father, says that he noticed a change in her manner some days ago. She locked herself in the bedroom. Aug 6 - She went with her little girl to baths, became very uncontrollable, had to be assisted from the water when she became very violent and abusive.
Discharged recovered on 20th November 1907.
26th August 1911 (No. 7718) with Recurrent Mania, the cause 'heredity' - both mother and sister were patients at the asylum - to 26th January 1912 when she was discharged recovered.
The Medical Certificate reads: I. Her incoherent continual talk, peculiar motion and gesticulations, habits changed. She is addicted to wander, and has threatened her sister n law. II. Sergeant Davies, Penrhyndeudraeth, states that he found her about 11.30 pm, August 24th, 1911, wandering along the streets in a very excitable state, with two carpet bags, one of which contained knifes and forks, very rambling in her talk. She had also smashed windows and acted very violent.
Readmissions:
13th July 1923 (No. 10119) diagnosed with Recurrent Mania.
The Medical Certificate reads:
Wild and rambling talk.
Very excited.
Incoherent speech.
Insomnia. Wandering about. Refusing food. (by JW, husband). Discharged recovered 27th December 1923 after a 2 month trial.
25th April 1924 (No. 10288) with very similar symptoms -' wild and vacant appearance, incoherent speech' - and again diagnosed with Mania.
Discharged recovered 13th January 1925 after a 2 month trial.
11th December1925 (No. 10569) with a diagnosis of Recurrent Mania. The Medical Certificate reads: Very excitable and talkative, her talk being disjointed.
Leaves her home and rambles about.
Her husband, J W, states:
My wife at the commencement upsets the furniture in the house, then ties them up ready to be thrown away. Last night she did not stop talking and disturbed everyone sleeping in the house.
She has been telling Miss Griffith that I have called her a liar.
After a failed trial in 1926, AYW remained in care until her death on 22nd August 1933 from a tubercular ischio- rectal abscess.
Her case notes indicate recurring maniacal attacks with remissions of short duration: 'The maniacal attacks recur regularly every month and last a week or ten days.
Her excitement is usually intense and there is marked loss of control with quarrelsome tendencies and abusive language. She can employ herself in the quiet intervals'.
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