instruction: hi doctor I am concerned about one of my relatives she may have some psychiatric problems first she faced a problem in her life before 10 years she believes in different sociology and culture she has a fantasy of smoking drinking and living together she does not believe in marriage she becomes angry if someone tries to correct her after that she had taken care by several doctors but the problems never uprooted for one and a half year she is running through the treatment she made the first visit only after that her parents are visiting with those doctors as a witness I noticed some irrelevant behavior 10 days ago which makes us very annoying I have a chronological prescription my only question is at this moment is she able to enjoy her marriage life if she gets married will she able to get pregnant please describe the family life difficulties including sex life I will be very thankful to you
output: hi I will summarize the clinically relevant aspects of her case the illness started early around the age of 17 years it has not cleared completely until yet and she has not returned to her previous personality the symptoms are suggestive of paranoid schizophrenia or bipolar disorder though more information and detailed history will be required to confirm it these factors suggest a poor prognosis and incomplete recovery from the illness her future will be decided by how much her symptoms improve if she visits the psychiatrist regularly and takes electroconvulsive therapy if the doctor suggests then her situation is likely to improve but at the current situation she does not appear to be mentally fit for marriage or children marriage is stressful in itself and she might not be able to handle the stress though there is no direct effect of the disease on her ability to get pregnant a mentally healthy mother is required to take care of herself during pregnancy and the baby after childbirth she currently does not appear to be capable of handling the stress of pregnancy and childbirth besides pregnancy and delivery are stressful and might worsen her psychological condition also the medicines that she takes might affect her ability to get pregnant and maintain a healthy pregnancy I would like to recommend a course of electroconvulsive therapy it works better than most medicines in such cases for further information consult a psychiatrist online