Rethinking Psychiatric Monitoring in Sensory-impaired Patients

Abstract This case series describes three individuals with congenital deafness and muteness, lacking formal communication skills, who presented with progressive behavioral changes and were diagnosed with schizophrenia or related disorders. Monitoring their progress was challenging due to communication barriers, necessitating the development of a modified bedside assessment scale tailored for individuals with congenital disabilities. The scale incorporated components from conventional psychiatric assessment tools (Positive and Negative Syndrome Scale and Brief Psychiatric Rating Scale) adjusted for patients with severe communication limitations. Importantly, the scale included a separate section to document the symptoms that relatives described as abnormal for the patient, even if these symptoms were not immediately considered clinically relevant by mental health professionals. These symptoms, often overlooked in patients with normal sensory abilities, proved essential in monitoring the progress of patients with limited communication abilities. The outcomes demonstrate that this tailored approach was effective in tracking symptom progression and guiding treatment.