For this Assignment, you practice assessing and diagnosing patients with anxiety disorders, PTSD, and OCD. Review the DSM-5 criteria for the disorders within these classifications before you get started, as you will be asked to justify your differential diagnosis with DSM-5 criteria.

To Prepare:

· View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.

· Consider what history would be necessary to collect from this patient.

· Consider what interview questions you would need to ask this patient.

· Identify at least three possible differential diagnoses for the patient.

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.

Incorporate the following into your responses in the template:

· Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?

· Objective: What observations did you make during the psychiatric assessment??

· Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.

· Reflection notes: What would you do differently with this client if you could conduct the session over??Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

Training Title 40

Name: Ms. Barbara Weider Gender: female Age: 56 years old

T-99.0 P-99 R 24 BP 132/89 Ht 5’4 Wt 168lbs

Background: Lives with her husband in Knoxville, TN, has one daughter age 23. She has never worked. Raised by mother, she never knew her father. Mother with hx of anxiety; no substance hx for patient or family. No previous psychiatric treatment. Has one glass red wine with dinner. Sleeps10-12hrs; appetite decreased. Has overactive bladder, untreated. Allergic to Phenergan; complains of headaches, takes prn ibuprofen, has diarrhea once weekly, takes OTC Imodium.

BEGIN TRANSCRIPT:

Weider -She nervously plays with her scarf as she breathes anxiously]

Physician- Hello Mrs. Weider. Are you ok? Do you want some water or something?

WEIDRE I’m ok. I’m fine.

Physician- I understand you wanted to see me today.

Patient- She breathes anxiously]

Patient- I just really needed to sit and talk.

Physician- Well, tell me what’s wrong, what are you feeling?

Patient- I’m just so… so unsure. I’m tired of being stuck in my house. I don’t like it.

Physician- Stuck in your house? Do you have difficultly leaving your house?

Patient- Yes. All the time.

Physician- When do you go out?

Patient…maybe, once or twice.

Physician- A day?

Patient- [She clutches her hands to her chest]

Patient- A week. Tuesdays and Saturdays.

Physician- Why Tuesday and Saturday?

Patient- Because when my husband gets home, he can go with me.

Physician- What do you do when you go out?

Patient- I take walks.

Physician- Where do you walk?

Patient- I only go to the end of the block, and then I cross the street, and turn around, and I go back around the cul-de-sac. I’ll do that three times. [Losing breathe] No more, then I have to go back inside… I also go in my backyard. That’s usually okay.

Physician- On the walks, why do you have to go back after three times? What happens?

Patient- [She nervously looks around] I just can’t go any further.