COUN5017 Mental Health

Presenting Concerns:  Case of Kimi

An analysis of the case study suggests that Kimi presents symptoms related to unhealthy eating patterns that are manifested by her behaviour of binge eating, followed by purging, by vomiting. The most common symptoms that she exhibits include eating large amounts of food in sohort time intervals, and her subsequent attempts to get rid of the consumed food. All individuals suffer stress due to a multitude of different factors that heighten their mental anxiety (Westerberg & Waitz, 2013). Stress faced by Kimi due to problems in her relationship with her husband makes her act in a compulsive way and adapt poor eating habits. The symptoms fit with the perspective of a mental health problem that focuses on rapid and out-of-control eating. It can be categorized as a mental disorder due to the fact that it encompasses a plerhora of underlying factors such as, genetics, neurochemical changes, low self-esteem, and lack of confidence (Gianini, White & Masheb, 2013).

Differential Diagnosis:  Case of Kimi

The DSM criteria for mental diagnosis was thoroughly viewed before diagnosing the her symptoms as binge eating disorder. Intitally it was evaluated whether the symptoms occurred due to direct impacts of any physiological condition or medical condition. This was followed by categorizing it into psychotic disorder as it occurred due to general medical conditions, since it was not induced due to action of psychoactive drugs. The DSM-5 criteira for eating disorders were matched to her symptoms and evaluated (Hudson et al., 2012). Kimi showed similarities with the DSM features related to recurrent binge eating episodes, marked distress, absence of inappropriate compensatory behaviour, and eating alone whe feeling depressed and being guilty afterwards. Presence of these critieria helped in differential diagnosis of disorders.

Evaluation of Assessment Results:  Case of Kimi

The SCOFF questionnaire will be used to assess the prevailing conditions. Questions related to whether Kimi made herself sick while she felt uncomfortably full, if shew worried about losing control over her eating will be asked. She will also be questioned if she had lost more than 1 stone weight in the past three months (Solmi et al., 2015). Further questions related to if she considers herself fat and what food items dominated her life will also be asked. An analysis of the results and her reports will help in screening binge eating disorder. The DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult will also be used for assessing the symptoms presented by Kimi. It will facilitate in determining her mental health domain and identify the probable prognosis and treatment of her condition (Clarke & Kuhl, 2014).

DSM and ICD Diagnosis:  Case of Kimi

An analysis of the symptoms that are manifested by Kimi suggests that that she is suffering from binge eating disorder. The ICD and DSM codes for binge eating disorder are 307.51 and F50.8 respectively. The diagnosis can be considered appropriate due to the fact that this disorder is commonly characterized by compulsive overeating and consumption of abnormal food proportions due to lack of control. The episodes are generally exhibited twice a week. A discussion with Kimi provided the information that she regularly indulges in eating unhealthy foods due to the stress and depression she faces, after her husband left her. The strong psychological correlation of her depression with the eating habits and her dissatisfaction and low self-esteem confirm the diagnosis.

Medication Referral/Consultation:  Case of Kimi

Research evidences suggest that binge eating disorders should be managed by addressing both physical and psychological sife effects. Dietary counseling and cognitive behavioural therapy will be most effective for treating this condition. More than 50% BED patients have demonstrated complete remission from the abnormal eating on CBT  administration. Further benefits are also related to its success in addressing psychiatric cormorbidites and self-image issues. In addition, antidepressants, anti-obestiy medicines and anticonvulsants can also be administered. Use of SSRI such as, fluvoxamine or fluoxetine will reduce her weight and binge eating symptoms. Anticonvulsants like zonisamide and topiramate will suppress appetite. However major contradictions are related to the fact that these medications can lead to insomnia, nausea, fatigue, tremor and weight gain, as well.

Presenting Concerns:  Case of Julio

Most common symptoms that are manifested by Julio include difficulty in remembering relevant information, problems in concentration on tasks, organizing events, and following instructions. The symptoms are a combination of several persistent problems that are associated with impulsive behaviour, without hyperactivity. The symptoms create significant impacts on the person’s daily functioning and result in restlessness and impulsiveness. Poor skills in managing work, problems in prioritizing, disorganisaiton and multitasking troubles fit with the perspective that it shows devition from normal mental states and makes it difficult for a person to pay sustained attention.

Differential Diagnosis:  Case of Julio

The developmental trajectory and behavioural symptoms were reviewed for diagnosing the mental condition. Julio was diagnosed on the basis of presence of some behaviours such as not giving close attention to detailed information or making careless mistakes, trouble in keeping attention on activities, not listening to people when being spoken directly and failing to follow appropriate instructions in the workplace (Willcutt, 2012). Similar reports were provided by Julio, in addition to his difficulty in organizing activities and getting easily distracted. This helped in differential diagnosis of attention-deficit/hyperactivity disorder, predominantly inattentive presentation.

Evalaution of Assessment Results:  Case of Julio

The Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist will be used for assessment of the mental conditions (Van de Glind et al., 2013). Questions related to the frequency of events related to trouble in wrapping up fine details of a work, difficulties in remembering obligations and appointments, squirming or fidgeting with the hands, making careless mistakes, difficulty in keeping attention and distracted by noise or other things will be asked (Barkley, 2012). Responses of the client will help in evaluating the prevailing mental condition related to ADHD with predominance in inattentive symptoms. Owing to the fact that adult ADHD symtoms can frequently overlap with a range of psychiatric comorbidities, this screener will help in analyzing the results.

DSM and ICD Diagnosis:  Case of Julio

The mental symptoms presented by Julio are diagnosed to be Attention deficit hyperactivity disorder predominantly inattentive, commonly referred to as ADHD-PI. The ICD and DSM codes for the condition are 314.00 and F90.0, respectively. Julio’s diagnosis can be considered appropriate as his symptoms match the diagnostic criteria. He reports difficulty in listening to his boss’s instructions during direct conversation. He also failed to provide close attention to details that were told to him while organizing office events. Thus, responses and self-reports that accurately matched the assessment tool questions and DSM-V critieria helps in confirming the diagnosis.

Medication Referral/Consultation:  Case of Julio

Major treatment approaches should include cognitive behavioural therapy, life coaching, job coaching and relaxation training. CBT will help in lowering rates of inattentive behaviour and will also enhance self-esteem. Researche evidences suggest that relaxation training and job coaching will helped in lowering levels of stress, anxiety, and improving on-the-job performance (Antshel, Faraone & Gordon, 2012). Fast acting amphetamine mixed salts that trigger dopamine release in synaptic cleft will act as potential medications for the condition. Fast acting methylphenidate, a dopamine reuptake inhibitor can also be administered. However, the major contradictions are related to restlessness, tremor, weakness, blurred vision and sleep problems (Fredriksen et al., 2013).

Presenting Concerns:  Case of Reese

Most common symptoms that are presented by Reese include excessive or abnormal reactions to identifiable life stressors. Her symptoms occue when she failed tp adjust or was unable to cope with major life events related to failure of her husband in meeting the pre-wedding contract rules. This added stress to her life (Strain, 2015). It culminated into feeling of hopelessness, anxiety, and miserability. The symptoms presented by Reese are also indicative of situational depression. Other common signs and symptoms manifested in this case include, worry, nervousness, crying spells, and sorrow. The symptoms fit within mental health due to the fact that presence of psychological conditions result in inability of an individual to adjust to particular events or conditions, which are not considered stressful by other people.

Differential Diagnosis:  Case of Reese

Intitally it was evaluated whether the disorder occurred due to influence of medical or physiological condition, followed by assessing the impacts of substance abuse or psychoactive drugs on the underlying conditions. It was difficult to diagnose the condition due to presence of symptoms that overlap with other mental abnormalities. The DSM-V critieria for adjustment disorders were evaluated by checking presence of behavioral or emotional symptoms in response to identifiable stressors (failure of her husband to follow the rules and work appropriately according to the contract). It was assessed whether the ongoing distress was not any form of escalation of already exisiting mental conditions (Casey, 2014). Furthermore, the differential diagnosis also included a verification that the disorder occurred firtst before presentation of anxiety or depression.

Evalaution of Assessment Results:  Case of Reese

A screeing scale for adjustment disorders: ADNM-6 will be used for the assessment.  Reese will be made to rethink about the stressful condition and its burden on her life (Bachem, 2016). She will also be asked to respond to questions on withdrawing from her friends, and family, suppressing her feelings, lack of sleep, and apathy. The self-rated The DSM-5 Level 1 Cross-Cutting Symptom Measure will also be used to assess prevailing mental health domains that exist in this psychiatric condition.

DSM and ICD Diagnosis:  Case of Reese

Diagnosis of the condition suggests that Reese is suffering from Adjustment disorder, With anxiety. The ICD and DSM codes for the same are 309.24 and F43.22, respectively. Confirmation of positive diagnosis is established by the fact that Reese reports of condition and situations that confirm her failure to adjust to or cope with her husband’s ways of conduct, related to his incapability to earn the predecided amount of money or follow the rules of work for each day (Boelen & Prigerson, 2012).

Medication Referral/Consultation:  Case of Reese

Psychotherapy is an effective treatment that can be administered upon Reese. It will bring about behaviour changes and symptom relief. This treatment will allow Reese to put her rage or distress into words rather than destructive actons (Deacon, 2013). Crisis intervention and counseling her along with her husband will facilitate a better understanding of the preferences and demands of each partner. Pharmacological interventions will include administration of anxiolytics, benzodiazepines, alprazolam, and tianeptine. Their effectiveness in treating patients with AD, in combination with anxiety have been proved by several research studies. However, the major side effects will include diarrhea, dizziness, insomnia, dry mouth and drowsiness (Bet et al., 2013).

References

Antshel, K. M., Faraone, S. V., & Gordon, M. (2012). Cognitive behavioral treatment outcomes in adolescent ADHD. Focus, 10(3), 334-345. https://doi.org/10.1176/appi.focus.10.3.334

Bachem, R. (2016). Screening scale for adjustment disorders: ADNM-?6. Retrieved from- https://www.psychology.uzh.ch/dam/jcr:ffffffff-b39e-febf-0000-000067fe4f38/Screeningscale.pdf

Barkley, R. A. (2012). Distinguishing sluggish cognitive tempo from attention-deficit/hyperactivity disorder in adults. Journal of Abnormal Psychology, 121(4), 978. Retrieved from- https://psycnet.apa.org/buy/2011-10368-001

Bet, P. M., Hugtenburg, J. G., Penninx, B. W., & Hoogendijk, W. J. (2013). Side effects of antidepressants during long-term use in a naturalistic setting. European neuropsychopharmacology, 23(11), 1443-1451. https://doi.org/10.1016/j.euroneuro.2013.05.001

Boelen, P. A., & Prigerson, H. G. (2012). Commentary on the inclusion of persistent complex bereavement-related disorder in DSM-5. Death Studies, 36(9), 771-794. https://doi.org/10.1080/07481187.2012.706982

Casey, P. (2014). Adjustment disorder: new developments. Current psychiatry reports, 16(6), 451. https://doi.org/10.1007/s11920-014-0451-2

Clarke, D. E., & Kuhl, E. A. (2014). DSM?5 cross?cutting symptom measures: a step towards the future of psychiatric care?. World Psychiatry, 13(3), 314-316. DOI: 10.1002/wps.20154

Deacon, B. J. (2013). The biomedical model of mental disorder: A critical analysis of its validity, utility, and effects on psychotherapy research. Clinical psychology review, 33(7), 846-861. https://doi.org/10.1016/j.cpr.2012.09.007

Fredriksen, M., Halmøy, A., Faraone, S. V., & Haavik, J. (2013). Long-term efficacy and safety of treatment with stimulants and atomoxetine in adult ADHD: a review of controlled and naturalistic studies. European Neuropsychopharmacology, 23(6), 508-527. https://doi.org/10.1016/j.euroneuro.2012.07.016

Gianini, L. M., White, M. A., & Masheb, R. M. (2013). Eating pathology, emotion regulation, and emotional overeating in obese adults with binge eating disorder. Eating behaviors, 14(3), 309-313. https://doi.org/10.1016/j.eatbeh.2013.05.008

Hudson, J. I., Coit, C. E., Lalonde, J. K., & Pope, H. G. (2012). By how much will the proposed new DSM?5 criteria increase the prevalence of binge eating disorder?. International Journal of Eating Disorders, 45(1), 139-141. DOI: 10.1002/eat.20890

Solmi, F., Hatch, S. L., Hotopf, M., Treasure, J., & Micali, N. (2015). Validation of the SCOFF questionnaire for eating disorders in a multiethnic general population sample. International Journal of Eating Disorders, 48(3), 312-316. DOI: 10.1002/eat.22373

Strain, J. J. (2015). Adjustment disorders. Encyclopedia of Psychopharmacology, 36-39. https://doi.org/10.1007/978-3-642-36172-2_357

Van de Glind, G., van den Brink, W., Koeter, M. W., Carpentier, P. J., van Emmerik-van Oortmerssen, K., Kaye, S., … & Moggi, F. (2013). Validity of the Adult ADHD Self-Report Scale (ASRS) as a screener for adult ADHD in treatment seeking substance use disorder patients. Drug & Alcohol Dependence, 132(3), 587-596. https://doi.org/10.1016/j.drugalcdep.2013.09.026

Westerberg, D. P., & Waitz, M. (2013). Binge-eating disorder. Osteopathic Family Physician, 5(6), 230-233. https://doi.org/10.1016/j.osfp.2013.06.003

Willcutt, E. G. (2012). The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics, 9(3), 490-499. https://doi.org/10.1007/s13311-012-0135-8