Question

Case Study

Identifying Factors:

Carmen Matthews is a 41-year-old separated Hispanic mother of two children, ages 10 and 12. She works full-time as a real estate agent. She is referred by her counselor.

Chief Complaint:

“I am so worried all the time. I feel like I’m caught in a nightmare.”

History of Present Illness:

The patient reports increased anxiety since her husband abruptly left town with his secretary about 8 months ago. She complains of constant worrying about paying her bills because of a downturn in the real estate market that reduced her income. Three months ago, she began to have more difficulty falling asleep, reporting that it can take her as much as 2 to 3 hours because she can’t stop worrying about how to provide for her children and how she will ever keep up with her mortgage and auto payments.

She estimates her total sleep to be 4 hours a night. In addition to difficulty falling asleep, she complains of fatigue, impaired concentration, and muscle tension, which are having a detrimental effect on her performance at work She also complains of frequent headaches, which are not typical for her. She denies depressed mood or suicidal ideation, intent, and plan. She describes herself as a strong, positive person who has always been able to deal with her own problems, although she admits that she has always had a tendency to worry. She has no family in town and few close friends.

Current Medications:

None.

Substance Abuse:

Carmen denies use of alcohol, tobacco, and all other licit or illicit drugs. She drinks about 4 cups of tea a day.

what would be the patient’s psychiatric diagnosis using the DSM 5?

What additional information would have been helpful?

What would you include in a biopsychosocial treatment plan for the patient in addition to pharmacotherapy?

Answer 1

Patient psychiatric diagnosis using the DSM 5 is Generalized anxiety disorder
It is charecterized by excessive,exaggerated anxiety and worry about everyday life events..it interferes with daily functioning and well being..patient having all GAD symptoms like
-Excessive tension
-Restlessness,irritation
-Muscle tension
-Head ache
-difficulty concentrating
-excessive self-confidence
-fatigue,insomnia
-suicidal thoughts
GAD also may become worse during periods of stress and use of and withdrawel from additive substances including alcohol,caffeine and nicotine can also worsen anxiety..
Biopsychosocial treatment plan include:
It is useful to treat the patient with underlying causes,it includes
-Deep breathing exercise
-Muscle relaxation technique
-Meditation
-electromyogram(EMG) to measure muscle anxiety and tension..it is used for back pain,headache,anxiety disorder..
-Thermal to treat headache by measuring skin temperature
-electroenchephalography(EEG)
-electrodermal activity to measure the anxiety level
-Heart rate variability to measure anxiety
Biopssychosocial treatment sued with condition like anxiety,headache, and chronic pain.Psychiatrist or psychologist can provide this treatement..
Parmacotherapy:
Minor tranquilizers to remove anxiety,muscle tension and restlessness
Benzodiazepines combined with antidepressants can be used..