Mike's Case Study

Mike's Case Study

Question 1: Assesses your ability to identify symptoms and differential diagnoses, and to demonstrate hypothesis testing, clinical decision making and a working knowledge of the DSM-IV. Clinical decision making involved in determining a diagnosis involves a process of data gathering and hypothesis testing.

Answer:

The case history of Mike represents that he has been going through severe psychiatric problems. The fact that he is not able to face anyone and do not have any social relationships make it quite clear that he is uncomfortable with the people around him. He lacks confidence and he also does not appear to be interested in making social relationships (Framingham, 2011). His underlying signs and symptoms make me able to diagnose him with obsessive compulsive disorder. The differential diagnosis always remains extremely difficult especially in the field of psychiatry. In order to demonstrate the hypothesis testing and clinical decision making efficiency; the DSM IV is assumed to be an important tool (APP, 2001).

DSM IV Criteria

Signs or Symptoms

Criteria Met (Y/N/More Info Needed)

A. Either obsessions or compulsions:

Obsessions as defined by (1), (2), (3), and (4):

(1) recurrent & persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress (2) the thoughts, impulses, or images are not simply excessive worries about real-life problems (3) the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action (4) the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)

Fear in People

Worrying about issues like being late and doing things which can embarrass him

Nausea

Churning in Stomach

Trembling

Inability to sit still

Physically tired from worrying

Worthless Person

Feeling of committing suicides

Criteria met; however, there is still a need to run some tests in order to make a confident conclusion about the disease.

Compulsions as defined by (1) and (2):

(1) repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly (2) the behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive

Mike does not represent any signs or symptoms which can be related to compulsions.

Repetitive behaviors are reported in Mike; however, in my opinion his symptoms met the criteria of obsessions. On the other hand, the actions of Mike can be categorized as response to the obsessions.

B. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. This does not apply to children.

Mike does realize that his feelings are sometimes ...