Discussion: Video Report of Your Case Consultation: Presenting and Validating Diagnosis

In this Discussion, you first present to your peers the case collaboration begun in Week 4. Note: You make this presentation individually—you do not present with your partner. Your colleagues then review your diagnosis for validity, recommending an evidence-based tool to use in your case.Such tools help confirm the details and validity of a diagnosis. Measures also help clinicians notice other patterns in a disorder that might otherwise be missed. By confirming an accurate diagnosis through a measurement instrument, a social worker ensures that the appropriate evidence-based treatment is used.****Post the following two pieces: I WILL TAKE THE INFORMATION GIVEN FOR THE KALTURA MEDIA SECTION AND PUT INTO MY PERSONAL VIDEO!!!!!******Use the Kaltura Media uploader to upload a 3- to 5-minute video in which you:Briefly summarize your case, highlighting the diagnostic symptoms seen in the case.Describe your decision-making process for identifying the key problems in the case and the differential eliminations for your case.Identify the diagnosis of the client in the case. Explain the diagnosis by providing the supporting DSM-5 criteria with specific examples of how your client met those criteria.Include a transcript and/or edit closed captioning on your video to ensure your presentation is accessible to colleagues of differing abilities.*********Post a fully coded DSM-5 diagnosis. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention).***WEEK 4 CASEWeek 4 Collaboration Case of JuniorPosted on: Saturday, September 19, 2020 1:55:13 PM EDTCASE OF JUNIOR DEMOGRAPHIC DATA This is a 39 yr old white male’s first admission to a psychiatric hospital. Patient’s wife is age 40. The couple have three children: son 15, daughter 12, son 9. The family is Baptist. Junior’s currently employed as a Certified Public Accountant in Mississippi. Junior has been married for 19 years. CHIEF COMPLAINT “Anxiety and depression.” HISTORY OF PRESENT ILLNESS Junior states that this year has been very trying for him. His mother-in-law-died suddenly and the three children have been sick with chickenpox and flu. Junior has been moody and depressed since late Fall (interview takes place in April, 2020) and in January, he,- himself, had the flu. He was treated with Humira for chronic colitis. His age 40 physical was coming up and he was very worried about it. In February, he was also treated with Lotronex. Junior was also worried because his father had a history of mood swings and depression and was treated with electroconvulsive therapy. Junior was hospitalized at a general hospital’s psychiatric unit, but, according to Junior was released prematurely. He said he didn’t feel well and was gradually getting rougher with the kids. He was taken by ambulance back to the general hospital’s emergency room, where he was, according to his wife, “paranoid.” His wife also said that Junior was “psychotic” in the ambulance, thinking that there was a plot against him and reeling he was poisoned. Junior said he “couldn’t cope” after discharge from the general hospital and that he was still “depressed.” He said that his concentration was off, he lost 24 lbs recently, was always anxious and was suspicious of people. He equates this to job stress, being that he was a managerial accountant in charge of a large food processing corporation. He blames that start of the whole episode of “depression” on the flu and aggravation of his inflammatory bowel disease. He said this also caused marital difficulties. Another problem was that he always worried about his job and possibly being fired, which may be a possibility. He also constantly worries about his large mortgage payment and the fact that his wife doesn’t work. He said they have a new luxury car and that he has to work very hard to keep this lifestyle. Junior also described being plagued with bad habits. He said that his habits included: having to bang up against the refrigerator door 4 times each time he closed it; having to look under all the living room furniture each evening for dust and if he found any dust having to vacuum the whole living room; having to count the cans of food in his kitchen cabinets, making sure there were always an even number of cans in the cabinets. He said he would think about these things until he did his “bad habit” and then he would feel better. FAMILY HISTORY Junior described his childhood as pleasant, where he grew up in Tupolo and went to a private school. Junior was able to discuss many of his childhood traumas. His mother died just before his 11th birthday and this made him very sad. His father remarried for the 3rd time and Junior did not like his stepmother. She was apparently very compulsive and always on him to clean his room, etc. Junior claims he was always shy, even as a teenager. He blamed this on his stepmother. He was interested in stamp collecting. PAST PSYCHIATRIC HISTORY Junior was treated at a general hospital’s psychiatric unit for three weeks. However, Junior was no better when he left than when he got there. He was given Xanax. Dates of his hospitalization were 3/11-3/24/20. MEDICAL HISTORY Junior had all the childhood diseases including chickenpox. He denied high fevers, seizures or head injuries. He denied medical or surgical hospitalizations. His only significant medical problem was chronic colitis. MENTAL STATUS EXAMINATION Junior is oriented to time, place and person and has an excellent fund of knowledge. He could do serial 7’s and all memory tests. Short and long-term memory seem adequate, but concentration is impaired. Patient denies homicidality but is ambivalent about suicidality. His affect was flat and his mood was dysphoric. He has not made a suicide attempt since his hospitalization at the general hospital but while at the general hospital he banged his head and tried to choke himself, allegedly with a toothbrush. He indicated that prior to and after his suicide attempt he was only sleeping 2-3 hours per night, waking up and worrying. Proverb interpretation is correct and if he had three wishes they would be “to leave here, go home and back to my job.” When asked how he sees himself in five years, he said “in a position, only healthier.” When asked what he would change about himself, he said “my personality.” While on the evaluation unit, Junior appeared to be very suspicious and was at times afraid something bad was going to happen to him. He also was markedly anxious about losing his job or his wife and family because he thought the newspapers were preparing a story about him and how sick he was. Junior thought the mental health aides were FBI agents observing him for the newspapers.

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