DSM 5-TR diagnosis
A 20-year-old woman with a past history of MDD is brought to the local emergency department (ED) by her family. She appears restless, pacing around the waiting room, and her parents say that she has recently been asked to leave her job as a tattoo artist. She has not slept for four nights, and her speech is rapid and quickly wanders off the point. She had recently purchased a $20,000 car and a $40,000 van to jump-start her mobile tattoo business in Naples, Florida. She is very reluctant to remain in the ED department because she has far too much to do and considers it a waste of everyone’s time. She believes that she is far too important to be held back by minions.
Summarize the clinical case.
What is the DSM 5-TR diagnosis based on the information provided in the case?
Which pharmacological treatment would you prescribe according to the clinical guidelines? Include the rationale for this treatment.
Which non-pharmacological treatment would you prescribe according to the clinical guidelines? Include the rationale for this treatment excluding a psychotherapeutic modality.
Include an assessment of the treatment’s appropriateness, cost, effectiveness, safety, and potential for patient adherence to the chosen medication. Use a local pharmacy to research the cost of the medication and provide the most cost-effective choice for the patient. Use great detail when answering questions 3-5.
post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
Sample Solution
Clinical Case Summary
A 20-year-old woman with a history of Major Depressive Disorder (MDD) presents to the emergency department (ED) brought by her family. She exhibits symptoms of mania, including psychomotor agitation, pressured speech, racing thoughts, flight of ideas, and grandiosity. She recently made significant impulsive purchases and displays poor judgment. Additionally, she reports sleep disturbance and an inflated sense of self-importance.
Full Answer Section
DSM-5-TR Diagnosis Based on the information provided, the most likely diagnosis according to the DSM-5-TR is Bipolar I Disorder, Single Manic Episode (American Psychiatric Association, 2022). Here's why this diagnosis is supported:- Manic Episode: The patient exhibits several symptoms characteristic of a manic episode, including:
- Psychomotor agitation (pacing)
- Pressured speech (rapid, jumping from topic to topic)
- Flight of ideas (rapidly shifting thoughts)
- Grandiosity (believing she's "too important")
- Decreased need for sleep (not sleeping for four nights)
- Poor judgment (purchasing expensive vehicles impulsively)
- Increased distractibility (speech wandering off point)
- Bipolar I Disorder: The presence of a manic episode without a current depressive episode is indicative of Bipolar I Disorder.
- MDD History: Her past history of MDD suggests a vulnerability to mood episodes, further supporting the Bipolar I diagnosis.
- Effectiveness: Lithium has a well-established track record of efficacy in controlling manic episodes and preventing future episodes (APA, 2020).
- Mood Stabilization: It acts as a mood stabilizer, helping to regulate both manic and depressive episodes.
- Long-Term Management: Lithium is effective for long-term management of Bipolar I Disorder, reducing the risk of relapse.
- Symptoms and phases of Bipolar I Disorder.
- Medication adherence and potential side effects.
- Healthy lifestyle choices to support mood stability (e.g., sleep hygiene, exercise, stress management).
- Early identification of warning signs of relapse.
- Empowerment: Providing knowledge about the disorder empowers the patient and family to manage the condition more effectively.
- Improved Adherence: Understanding the benefits and potential side effects of medication can contribute to improved medication adherence.
- Relapse Prevention: Learning to identify early warning signs of relapse allows for timely interventions to prevent full-blown episodes.