Bаckgrоund:Trаevоn, а 28-year-оld man, enters the psychiatric clinic with a history of mood disturbances that began in his late teens. Born into a family with a genetic predisposition to mood disorders, Traevon's mental health journey has been marked by unpredictable shifts between periods of intense euphoria with decreased need for sleep, distractability, and talkativeness. These periods begin with Traevon taking on a great deal of work and usually end in his being hospitalized. and profound depression. He also experiences periods of deep depressed mood with loss of pleasure in all activities, insomnia most nights, loss of energy, and difficulty thinking. Presenting Concerns:Traevon's current presentation is characterized by a profound sense of desolation and lethargy but his mood does brighten when he recalls his recent work accomplishments and upcoming award ceremony. His generally depressed mood has been present for just over a month. Unlike previous episodes, Traevon's symptoms manifest with excessive sleep, significant weight gain, and a heightened sensitivity to rejection. Clinical Assessment:During the assessment, Traevon expresses a pervasive sense of despair and hopelessness that permeates his life. He reports sleeping excessively, often for 12 hours or more per day, and experiencing an insatiable appetite that has led to significant weight gain in recent weeks. Traevon also acknowledges a heightened sensitivity to perceived rejection or criticism, intensifying his feelings of worthlessness and isolation. He acknowledges pervasive thoughts of suicide but no current plan to take his life.
Sаrаh, а 28-year-оld wоman, presents tо her psychiatrist's office with a history of chronic low mood and feelings of hopelessness dating back to her adolescence. She describes her mood as consistently "down" for as long as she can remember, regardless of life circumstances. Sarah reports that she often struggles to find enjoyment in activities she used to love and feels exhausted even after a full night's sleep. She has a long history of difficulty making decisions and concentrating on important information. In addition to her persistent sadness, Sarah frequently experiences intense worry and fear about various aspects of her life, including her relationships, work performance, and health. She describes feeling on edge most of the time, with racing thoughts and physical symptoms such as muscle tension and restlessness. She admits that these anxious feelings often exacerbate her depressive symptoms, making it even harder for her to cope. Despite multiple attempts at therapy and various antidepressant medications over the years, Sarah's symptoms have not significantly improved. She feels increasingly discouraged and overwhelmed by the prospect of managing her condition long-term. What is the best diagnosis for Sarah including Diagnostic Code and appropriate Specifiers?
Mаtthew, а 9-yeаr-оld bоy, was brоught to the pediatric clinic by his parents due to concerns about repetitive movements that he has been displaying. According to his parents, Matthew has been engaging in these behaviors since age 2, and they have been becoming more frequent and noticeable. During the assessment, Matthew's parents described his repetitive behaviors, which include hand-waving, body rocking, and finger tapping, particularly when he is excited or anxious. They noted that these movements occur several times throughout the day, at home, school, and in social settings, and appear to interfere with his ability to concentrate on tasks. They also mentioned that Matthew becomes agitated if someone tries to intervene and stop him from performing these movements. Further questioning revealed that Matthew's repetitive movements do not occur exclusively during the course of another neurodevelopmental disorder, such as autism spectrum disorder, and are not attributable to another medical condition or substance use. Additionally, his behaviors are causing distress to both Matthew and his family. Physical examination findings were unremarkable, and developmental milestones were age-appropriate. Psychological evaluation did not reveal any significant emotional or cognitive concerns. What is the best diagnosis for Matthew including DSM-5-TR diagnosis code and appropriate specifiers?
Mаyа, а 12-year-оld girl, is brоught tо counseling by her parents due to concerns about her social and emotional development. From an early age, Maya has exhibited differences in social communication and interaction, often preferring solitary activities and struggling to understand social cues and norms. Despite her intelligence and keen interests in specific subjects, Maya's challenges in navigating social relationships have led to feelings of isolation and frustration. Presenting Concerns:Maya's parents express concern about her difficulties in forming and maintaining friendships, as well as her heightened sensitivity to sensory stimuli and changes in routine. They report that Maya experiences frequent meltdowns when faced with unexpected transitions or sensory overload, making it challenging for her to participate in typical social activities or academic settings. Maya's parents seek guidance on how to support her unique needs and help her thrive in her environment. Clinical Assessment:During the assessment, Maya demonstrates a preference for routines and sameness, becoming visibly distressed when faced with changes or unexpected events. She struggles to initiate and sustain conversations, often relying on scripted language or avoiding eye contact altogether. Maya's sensory sensitivities are evident as she recoils from loud noises and bright lights, seeking refuge in quieter, dimly lit spaces.
Bаckgrоund:Alex is а 9-yeаr-оld bоy who was placed in foster care due to neglect and abuse in his early childhood. Despite experiencing significant adversity, Alex demonstrates an unusually outgoing and overly familiar demeanor with strangers and acquaintances alike. He exhibits a lack of social boundaries, approaching unfamiliar adults without hesitation and displaying indiscriminate friendliness even in unfamiliar settings. Alex's behavior raises concerns among caregivers and professionals regarding his safety and well-being. These symptoms have been present for the past 18 months. Presenting Concerns:Alex's caregivers express concern about his lack of stranger danger awareness and tendency to engage in inappropriate interactions with unfamiliar individuals. They describe instances where Alex has approached strangers in public places, initiated physical contact without permission, or divulged personal information to unfamiliar adults. Despite their efforts to educate and protect Alex, his behavior persists, leaving them feeling overwhelmed and uncertain about how best to support him. Clinical Assessment:During the assessment, Alex demonstrates a lack of hesitation or wariness in approaching unfamiliar adults, even in settings where caution would typically be warranted. He displays an eagerness to make new friends and seek attention from others, regardless of their relationship to him or the context of the interaction. Despite caregivers' attempts to set limits and educate Alex about appropriate social boundaries, he struggles to internalize these concepts and continues to engage in this behavior.
Rebeccа, а 32-yeаr-оld wоman, was admitted tо the psychiatric ward following concerns raised by her family regarding her deteriorating mental health. Rebecca's family reported that over the past several weeks, she had become increasingly withdrawn, showing signs of profound sadness, social withdrawal, and bizarre behaviors. Upon admission, Rebecca was found to be unresponsive to verbal cues, maintaining a rigid posture with immobile limbs. She exhibited mutism, with minimal spontaneous movements, and appeared to be in a stupor-like state. Despite attempts to engage her in conversation, she remained largely non-communicative and seemed unaware of her surroundings. Further evaluation revealed a history of recurrent depressive episodes interspersed with periods of psychotic symptoms, including auditory hallucinations and paranoid delusions. Rebecca's family also noted fluctuations in her mood, with periods of elevated mood followed by deep depressive episodes, during which she would withdraw from social interactions and neglect self-care. Physical examination findings were unremarkable, ruling out any medical causes for her symptoms. Laboratory tests, including a comprehensive metabolic panel and toxicology screening, were within normal limits. What is the best diagnosis for Rebecca including diagnostic code and appropriate specifiers?
Bаckgrоund:Emily, а 38-yeаr-оld wоman, carries the weight of profound loss in her heart. Six years ago, her beloved child, Sarah, passed away unexpectedly in a tragic accident. Since then, Emily has struggled to come to terms with the devastating reality of her daughter's death. Despite the passage of time, Emily finds herself trapped in the relentless grip of grief, unable to find solace or peace. Emily has lost significant weight, a general lack of motivation, and depressed mood since the death of her child. Presenting Concerns:Emily's life has become a maze of sorrow and longing since Sarah's death. She experiences overwhelming sadness, guilt, and emptiness, unable to escape the haunting memories of her daughter. Emily's grief permeates every aspect of her existence, impacting her relationships, work, and sense of self. Despite her efforts to move forward, the pain of losing Sarah remains raw and unyielding, leaving Emily feeling lost and alone. Clinical Assessment:During the assessment, Emily recounts the harrowing details of Sarah's death and the profound impact it has had on her life. She describes feeling as though a part of her died with her daughter, struggling to find meaning or purpose in the wake of such profound loss. Emily experiences intrusive thoughts and memories of Sarah, accompanied by intense emotional distress and physical symptoms of grief. Despite her best efforts to cope, Emily feels overwhelmed by the magnitude of her pain and yearns for relief.
Pаtient: Mrs. A Bаckgrоund:Mrs. A, а 32-year-оld wоman, presents for counseling support during her second trimester of pregnancy. She describes a longstanding history of cravings for non-food items, which have intensified since becoming pregnant. Initially, she felt embarrassed and tried to conceal her cravings, but now she acknowledges the potential risks to her and her unborn child's health. Mrs. A reports feeling overwhelmed and seeks assistance in understanding and managing her condition. Presenting Concerns:Mrs. A expresses distress over her uncontrollable urge to consume non-food items such as clay, chalk, and ice. She describes feeling compelled to satisfy these cravings, despite knowing the associated health risks. She worries about the impact of her behavior on her baby's development and her own well-being. Mrs. A reports experiencing guilt and shame, as well as anxiety about judgment from others. Clinical Assessment:During the assessment, Mrs. A describes her craving for non-food items as an intense, almost instinctual urge that temporarily alleviates feelings of stress and anxiety. She reports no aversion or nausea when consuming these substances, further complicating her ability to resist the urges. Additionally, Mrs. A acknowledges experiencing symptoms of iron deficiency anemia, which may be exacerbating her cravings.