Mental Disorders Essay, Research Paper

MENTAL DISORDERSThe DSM IV ( Diagnostic and Statistical Manual of Mental Disorders ) systems which was published in1994, represents the official categorization system used in the United States for diagnosingpsychological upsets. It gives specific standards that are used in diagnosing, along with otherinformation sing other characteristics that are sometimes seen in people with specific upsets and issuesthat are considered differential diagnosing ( separating between a primary upset and otherconditions that may be similar in some ways ) . All three of the patients in the instance surveies exhibitsymptoms that can be diagnosed through this system. James ChattertonOne instance trades with schizophrenic disorder, another with obsessive-compulsive upset, and the other withsubstance maltreatment upset ( specifically, substance-induced ) . However, induced temper upset couldrepresent an alternate diagnosing which should be considered. Although the old diagnosing is themost appropriate. All three patients exhibit features that enable them to be diagnosed throughthe DSM IV categorization system.When sing both the history and showing symptoms of this patient, it would look tat themost appropriate diagnosings would be schizophrenia & # 8211 ; paranoid type. An alternate diagnosing of mooddisorder with psychotic characteristics would hold to be considered, although this diagnosing seems much lesslikely than a primary diagnosing of schizophrenia.The primary characteristics of schizophrenic disorder autumn into a figure of classs. Characteristic symptomsinclude psychotic beliefs, hallucinations, disorganized address, grossly disorganized behaviour, every bit good assymptoms of affectional flattening ( e.g. , demoing a deficiency of scope of emotional response ) . Patients onlyneed to demo two of these characteristics for diagnosing. Other symptoms include grounds of major societal oroccupational disfunction. This may be reflected in a failure to map at an expected degree in termsof occupation or school public presentation, every bit good as major jobs in associating to others in societal state of affairss. Thedisorder must hold lasted for six months or more, and the patient must non demo grounds of a figure ofother conditions such as temper upset with depressive characteristics, or substance induced psychotic upset. James Chatterton displays a figure of characteristics that are extremely implicative of a diagnosing ofschizophrenia. He shows really unusual and unconventional behaviours. Indeed, he is said to hold had nofriends and displayed an uncharacteristic deficiency of involvement in the opposite sex during his adolescentyears. His jobs in societal operation are non merely indicated by his unusual behaviours and hid lackof interpersonal relationships but it is besides indicated by the fact that during his senior twelvemonth hissocial operation declined to the extent that he stopped go toing school and displayed a generalizedlack of involvement in making much of anything. Clearly, he shows grounds of societal disfunction. Possibly the characteristics most characteristic of schizophrenic disorder are the presence of psychotic beliefs andauditory hallucinations. Here it can be pointed out tat the patient had suggested to his cousin that sheshould non take her medicine, as it was a secret plan by a spiritual group to do her sterile. This, alongwith his talks about alien is declarative of delusional thought. Such psychotic beliefs are of thetype most normally seen in schizophrenics with paranoid characteristics. It can be noted that, even as a kid, the patient thought other people were speaking about him. Other authoritative schizophrenic characteristicsdisplayed by this patient include audile hallucinations, as when he noted that a adult female s voice wastelling him to make things. His inclination to express joy without evident ground. as though he had heardsomething, is besides supportive of the presence of audile hallucinations. The fact that the Mental StateExam found the patient to be disoriented in footings of non cognizing the vitamin D! Ate or where he was, besides is implicative of schizophrenic disorder by his deficiency of appropriate look offeelings. All in all, a battalion of characteristics strongly supports a diagnosing of Schizophrenia. Specifically, schizophrenia & # 8211 ; Paranoid Type. It can be noted that the Paranoid type of Schizophrenia isdiagnosed when the patient shows grounds of psychotic beliefs and other characteristics such as either disorganizedbehavior or inappropriate affect ( looks of feelings ) . His psychotic beliefs have already been discussed. Inappropriate affect is suggested by this inclination to express joy unsuitably for no evident ground. His clean facial look is besides implicative of level affect. While all of the above strongly supporta diagnosing of schizophrenic disorder, the fact that the patient shows grounds of sleep perturbation, weight loss, and has made what would be seen as a suicide effort makes it of import to see that he may expose amood upset with psychotic characteristics as these characteristics are all! suggestive of depression. The primary statement against this alternate diagnosing appears to be thepresence of audile hallucinations, which are infrequently found in temper upsets and the fact thatwhat appear to the primary symptoms of schizophrenic disorder in this patient make non needfully co-occur withevidence of depression as is the instance with psychotic characteristics ( e.g. , psychotic beliefs ) which are associated witha temper upset. Therefore, this alternate diagnosing appears much less likely than a diagnosing ofschizophrenia. Psychosis associated with substance maltreatment seems comparatively improbable due to the fact that

the patient has non enga

ged in serious substance abuse, although there appears to have been someexperimentation. It can be noted that, unlike the pseudo patient described by Rosenhan, this patient displays awide range of symptoms that clearly differentiates him from normal individuals. Treatment of a patientsuch as this would likely involve treatment with antipsychotic medications, perhaps combined withpsychotherapy. SARA WINKLERIt would seem that the most appropriate diagnosis for this patient would be Obsessive-CompulsiveDisorder. An alternative diagnosis would be Major Depressive Episode. According to DSM IV Criteria, theprimary features characteristic of Obsessive-Compulsive Disorder are either obsessions or compulsions. Here the patient experiences recurrent, persistent thought, impulses or images that are intrusive andcause marked anxiety or distress, that go beyond normal worrying about real life problems, and which theperson realizes are irrational and attempts to suppress or deal with through some thought or action. Alternatively, the person may experience repetitive behaviors which they feel compelled to perform. These behaviors are directed toward reducing anxiety or preventing some feared event or situation. Theseobsessions or compulsions are seen by the patient as being excessive or irrational, cause markeddistress, and interfere with the patients ability to function. It is obvious that Sara shows both obsessions and compulsions. Her obsessions take the form ofintrusive thoughts and impulses related to her arming her child. Her compulsive behaviors take the formof behaviors which represent attempts to ward off or prevent such threatening things from happening. Other characteristics of this patient might be seen as suggestive of a Depressive Disorder whichmight be considered as an alternative diagnosis. In this regard it can be noted that the patient reportsfeelings of depression, shows a loss of interest in most activities, describes a lack of energy, andevidence of weight loss and sleep disturbance. All of these features are associated with DepressiveDisorder. While these features are clearly present, it could be argued that the primary diagnosis forthis patient should be Obsessive-Compulsive disorders it seems to be the case that depressive featureshave occurred secondary to the distress resulting from her obsessions and compulsions and the disruptionin her personal and family life that has resulted. Treatment of this patient would likely involve dealing with several issues. The treatment ofobsessive-compulsive disorder has been approached through the use of pharmacological treatments as in theuse of antidepressant drugs such as Prozac. Psychological treatment where the patient is exposed tosituations likely to result in increased compulsive behavior and where they are not allowed to engage incompulative behaviors have also been found to be useful. Either of these types of treatment might beuseful with this patient. DEAN WANNAMAKERThis case seems to present the most difficulties in terms of making a differential diagnosis. Itseems clear that this patient displays a substance abuse disorder of some type. Two specific diagnosesappear to most likely characterize his symptoms. The first is Substance-induced Psychotic Disorder. Myhypothesis is that this is the most appropriate primary diagnosis. The second is Substance-induced MoodDisorder with Depressive Features. The primary symptoms of Substance-induced Psychotic Disorder include prominent hallucinations ordelusions. It is suggested that there should be evidence that these symptoms developed during or withina month of substance intoxication or withdrawal, that symptoms are not better accounted for by anon-substance-induced psychotic disorder and that symptoms do not occur just during a delirium. For thisdiagnosis to be made it is also the case that the hallucinations or delusions should not be recognized bythe patient to be the result of substance abuse. This patient appears to clearly meet these criteria. First of all, he shows evidence of auditoryhallucinations that began when he was in his early 40 s. These hallucinations began after the onset ofbouts of heavy drinking and are described by his girlfriend as only occurring after he has been drinkingfor a while. The patient shows no insight into the fact that the voices he hears are related to hissubstance abuse. Of special concern is the fact that the voices he hears now speak to him regarding thetopic of death. This would raise concern over possible suicide attempts later. The patient also seems to meet the criteria for the alternative diagnosis of Substance-inducedMood Disorder with Depressive Features. He shows significant depression by his crying, weight loss sleepdisturbance, loss of interest in sex, and loss of energy. His recent thoughts about dying are alsosuggestive of significant depression. His girlfriend s statement that he has been depressed most of thetime for the last month and a half – not quite as long as he d been drinking suggests that the patient sdepression likely developed subsequent to alcohol abuse.Treatment might well involve participation in a substance abuse treatment program and helpingdevelop more adequate ways of coping with major stress so that he is less likely to abuse alcohol inattempting to cope with this stress. Psychotherapy would seem likely to be helpful in this regard. Given that both the psychotic symptoms and depression are substance abuse could be dealt with these othersymptoms (e.g., hallucinations, depression) should be greatly diminished.