Case Study Analysis
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Case Study Analysis
Case study 1: Patient Name: Bob
In this case study, Bob might be suffering from various medical conditions. The symptoms noted include agitation, anxiety, dependence on alcohol to calm down anxiousness and psychological instability developed during his childhood because his father was an alcoholic. The likely conditions diagnosed in this case study include dementia, alcohol withdrawal syndrome, and bipolar disorder. The conditions above are psychiatric possibilities of Bob’s condition.
A. Dementia
Diagnosis and Symptoms
A patient suffering from dementia displays signs of agitation. This is primarily because of the emotional and behavioral distress that is synonymous with this condition. Agitation can range from mild to severe with both scenarios likely to make the patient act in a manner that is unbecoming of their character (Freudenreich, 2008). Symptoms that indicate dementia and prove that Bob is likely to be suffering from this condition are as follows
– Pacing, rummaging or searching
– Irritability and frustration
Other symptoms include:
- hitting
- yelling
- biting
- threatening
- demanding attention
- obstinately refusing to engage in any activities
During the diagnosis process, the above-listed symptoms’ existence should be carefully determined during the evaluation. If the patient shows most of the symptoms outlined, they are likely to be suffering from dementia.
Treatment
Medical treatment is one of the methods that can be used to treat dementia. The main role of using pharmacological agents is to reduce the agitation.
A. prescribe antipsychotic. The first line of treatment is the use of antipsychotic, which reduces the anxiety, psychosis, or delirium (Freudenreich, 2008). A prescribed drug for this condition is Buspirone that manages the anxiety levels.
B. prescribe sedation. Sedation can also be considered in extreme cases of agitation and anxiety. The patient will be in a drowsy state for a few hours and will be calmer after the medication.
B. Bipolar Disorder
Diagnosis and Symptoms
Based on the symptoms exhibited by Bob, most of them are likely to be caused by anxiety, which in turn results in agitation. According to psychiatry, bipolar disorder is often characterized by anxiety. The pacing up and down shows restlessness of the patient (Freudenreich, 2008). The agitation expressed by the patient further proves that they are suffering from bipolar disorder. Additional symptoms of bipolar syndrome include:
– Inner tension
– Extreme anxiousness
– Hyper-arousal
– Agitation
– Impatience
Conclusively, the primary step in diagnosing bipolar disorder is conducting a psychological evaluation to develop a diagnosis correlating to the symptoms and establish the appropriate treatment for the condition.
Treatment
A. Prescribe anti-psychosis drugs. These medications have been considered transformative in terms of treating patients suffering from this condition. This is primarily because it has enabled the patients to live within the community without having to be admitted to a psychiatric institution for supervised treatment. When prescribing this medication, it is imperative to stress that the regimen to be followed strictly to guarantee compliance and enable the patient to prolong life and increase its quality. Preferable medication to be prescribed is Clozapine with a daily dosage of 300- 700 mg. Its effectiveness is observed even in drug-resistant patients.
B.
Psychotherapy. Therapy, in
dealing with bipolar disorder is considered effective
as it addresses the cause of the
condition. In this case, Bob has internal conflictions such as his hatred for
his biological father for being an alcoholic as he was growing up. He regrets
and is ashamed of his alcoholism addiction,
as he does not want to be like his father. The combinations
of the anti-psychosis drugs in combination with interpersonal and social rhythm
therapy (Freudenreich, 2008) will enable the patient to deal with his mental struggles
caused by his childhood, and assist him in coping with the healing process in a
calmer way.
Case Study 2: Name: Steven
Attention Deficit Hyperactivity Disorder
Diagnosis and Symptoms
Steven’s symptoms
include disruptive behavior, disinterest in class, impatience, and meanness.
The likelihood etiology for this behavior is Attention Deficit Hyperactivity
Disorder (ADHD). This is one of the most common
conditions affecting children, adolescents,
and young adults (Freudenreich, 2008). According to the account provided by
Steven’s mother, some of the symptoms that her son is suffering are similar to
those exhibited by ADHD patients. The major
symptoms include
– difficulty in focusing on one
particular activity
- disinterest in talking to other people
- day dreaming
- failure to follow instructions given
- failure to focus on completing and organizing a task
- forgetting things, being easily distracted and missing details
- feeling bored with an activity or person after a short while
After a psychological evaluation, it is possible to observe the Steven is suffering from ADHD. This is because three aspects are considered in diagnosing a patient with ADHD. Firstly, hyperactivity is the primary sign (Fujii & Ahmed, 2007). The associated symptoms include being disruptive in school. This is observed when a child has trouble focusing on school activities or sitting still. Secondly, impulsivity is the secondary sign. It is characterized by impatience, making inappropriate comments, which can be viewed as being inconsiderate and mean. Thirdly, inattention is the final sign (Freudenreich, 2008). This is elaborated by the disinterest in doing activities, which might be enjoyable for other children. Based on the three aspects and the symptoms associated with these signs, it is true to state that Steven is suffering from ADHD. To establish this condition, the most important step that should be conducted is a psychological assessment. This can be combined by checking for other symptoms that can be indicative of other conditions.
Treatment
A. Pharmacological Interventions. The medication that can be prescribed for Steven is known as a stimulant. The effect of this medication is it creates a calming effect in children. The secondary effect is reducing impulsivity and hyperactivity (Freudenreich, 2008). Children who take this medication can learn, work, and focus well as well as improve their coordination. The stimulant medications that I would prefer the patient to take include Desoxyn, Concerta, and Desoxyn (Fujii & Ahmed, 2007). The side effects affect the children differently depending on their morphology. Some of these effects include sleeping problems and decreased appetite.
B. Psychotherapy. The type of therapy, which should be prescribed in this case study, is behavioral psychotherapy. The primary aim of this therapy is changing the behavior of the child. One of the best features of this therapeutic method is providing practical assistance. It involves assisting in the completion of schoolwork, organization of tasks and working through difficult issues, which might cause them to act out.
This therapy also provides the parents with adequate
information on how to assist the child in developing a second-thought mechanism
that requires a person to think through their action prior to committing them
(Fujii & Ahmed, 2007). Social skills are
also learned during this process. In this session, the child is
empowered with skills that enable them to socialize well with other children. This
includes being able to wait their turn
when sharing toys, requesting for help when necessary and responding to teasing
without acting in an unbecoming manner.
Case Study 3: Patient Name: Melinda
Schizophrenia
Diagnosis and Symptoms
The case study on Melinda is a classical example of a psychiatric condition. The likely diagnosis to be made is schizophrenia. This condition is usually observed in early adulthood, which is the stage that Melinda is. To further prove she is suffering from this condition, it is important to discuss the major symptoms associated with this disorder. They are as follows
A. Delusion. According to the patient, the biological department at her college is determined to alter the DNA in her brain using a high-powered laser. This can be termed as suffering from delusions. In this state, the patient is likely to describe that people in their surroundings are plotting against them because they possess extraordinary gifts and powers (Fujii & Ahmed, 2007).
B. Thought disorder.This symptom is characterized by patients typically failing to focus on one topic. This means a patient lacks logical reasoning. The speaking might be incoherent and muddled in some cases. This makes the patient feel as if their mind is being manipulated. In the case study, Melinda’s parents mention that their daughter started speaking nonsense, which is an excellent indicator of thought disorder, as she cannot express herself in an organized nor orderly manner.
Treatment
In diagnosing of this condition, as a psychiatric professional, it is important to note that it has been caused by an environmental trigger. In this case, the alienation from her parents, when she joined college, is the probable causative factor to her developing schizophrenia. The steps followed in the diagnosis include
1. Conducting a physical examination to observe the actions of the patient
2. Carrying out blood test to check the complete blood count
3. Conducting a psychological evaluation as an assessment of the patient’s mental Schizophrenia is treated on a long-term basis (Stone, Faraone & Tsuang, 2004). Two probable treatments are preferred. They are inclusive of psychosocial therapy and medication (Fujii & Ahmed, 2007). Hospitalization is considered the last option in severe cases where monitoring by medical practitioners is necessary.
A. Prescribe Antipsychotic Medication. In Melinda’s case, the likely treatment is antipsychotic medication to control the symptoms exhibited by the patient. Some of the second-generation medications prescribed include Abilify, Lurasidone, Ziprasidone, Clozapine, or Asenapine (Stubbe, 2007). Because Melinda has never shown any psychotic symptoms, injections are not necessary. Avtian should also be prescribed to calm down the patient when she experiences her delusion episodes. It is crucial to note that these medications are prescribed for anxiety, depression, and psychosis as well. The main reason for this multi-diagnostic treatment is that this condition is characterized by the symptoms above (Sachdev & Keshavan, 2010).
Ethical and Cultural Considerations when Treating Psychotic Disorders
Treating
patients suffering psychotic disorders requires several ethical considerations
to be respected. The first consideration is deciding whether to tell the
patient the truth when they are suffering from paranoia (Stubbe, 2007). In some
cases, the psychotherapists are allowed to withhold information in situations
where the patient has underlying emotional issues. This is because a
psychotherapist can risk the patient withholding the truth about their condition,
which might deter their healing process (Fujii & Ahmed, 2007). The second
aspect is deciding whether to support the ambitions of the patient. Especially,
this is in situations where the patient needs this motivation to improve the
quality of their life. Hence, in this instance, it is imperative to allow the
patient to contribute their input concerning their care.
References
Freudenreich, O. (2008). Psychotic disorders. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Fujii, D., & Ahmed, I. (2007). The spectrum of psychotic disorders. Cambridge, UK: Cambridge University Press.
Sachdev, P., & Keshavan, M. (2010). Secondary schizophrenia. Cambridge: Cambridge University Press.
Stone, W., Faraone, S., & Tsuang, M. (2004). Early clinical intervention and prevention in schizophrenia. Totowa, N.J.: Humana Press.
Stubbe, D. (2007). Child and adolescent psychiatry. Philadelphia: Lippincott Williams & Wilkins.