Pharmacological treatment
A 41-year-old man presents to his PCP with feelings of hopelessness, sadness, and helplessness. He says that he cries for no reason, and has difficulty sleeping. He noticed that the problems began about 6 weeks before, and he did not feel able to shrug them off. He has been drinking more alcohol than usual and has stopped going to work. When on his own, he admitted that he had thought of driving his car into the nearest canal.
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 including the name, dose, route and frequency of the drug in accordance with 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.
Sample Solution
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) is the latest edition of the American Psychiatric Association's professional reference book on mental health and brain-related conditions. It was published in 2022 and includes updates to the diagnostic criteria for more than 70 disorders, as well as the addition of a new diagnosis, prolonged grief disorder.
DSM-5-TR Diagnoses
The DSM-5-TR includes over 200 diagnoses, which are organized into the following categories:
- Neurodevelopmental disorders: These disorders are characterized by developmental delays or impairments in cognitive, social, or emotional functioning. Examples include autism spectrum disorder, intellectual disability, and attention-deficit/hyperactivity disorder (ADHD).
Full Answer Section
- Schizophrenia spectrum and other psychotic disorders: These disorders are characterized by a loss of contact with reality and may include hallucinations, delusions, and disorganized thinking and behavior. Examples include schizophrenia, schizoaffective disorder, and delusional disorder.
- Bipolar and related disorders: These disorders are characterized by mood swings that range from extreme highs to extreme lows. Examples include bipolar disorder, depressive disorder, and disruptive mood dysregulation disorder.
- Anxiety disorders: These disorders are characterized by excessive fear, worry, and anxiety. Examples include generalized anxiety disorder, social anxiety disorder, and phobias.
- Obsessive-compulsive and related disorders: These disorders are characterized by intrusive thoughts and repetitive behaviors. Examples include obsessive-compulsive disorder (OCD) and hoarding disorder.
- Trauma- and stressor-related disorders: These disorders develop in response to traumatic or stressful events. Examples include post-traumatic stress disorder (PTSD) and acute stress disorder.
- Dissociative disorders: These disorders are characterized by disturbances in identity, memory, and consciousness. Examples include dissociative identity disorder (DID) and depersonalization/derealization disorder.
- Somatic symptom and related disorders: These disorders are characterized by physical symptoms that are not caused by an underlying medical condition. Examples include somatoform disorder and conversion disorder.
- Feeding and eating disorders: These disorders are characterized by disturbances in eating behavior. Examples include anorexia nervosa and bulimia nervosa.
- Elimination disorders: These disorders are characterized by problems with urination or defecation. Examples include enuresis (bedwetting) and encopresis (accidents).
- Sleep-wake disorders: These disorders are characterized by problems with sleep. Examples include insomnia and hypersomnia.
- Sexual dysfunctions: These disorders are characterized by problems with sexual desire, arousal, orgasm, or pain.
- Gender dysphoria: This disorder is characterized by a strong and persistent feeling of discomfort or distress that is caused by a person's assigned sex at birth and their internal sense of gender.
- Provide accurate and reliable diagnoses to their patients.
- Develop appropriate treatment plans.
- Communicate with other mental health professionals and insurance companies.
- Conduct research on mental disorders.