Multiaxial Diagnosis of Joseph - Case Study Example

 Multiaxial Diagnosis Axis I 298.9 Psychotic Disorder Not Otherwise Specified. Axis II No Diagnosis Axis III None Axis IV Occupation Problem(Unemployment) Axiz V 21- 30(current) Mulitaxial Assessment Summary The diagnosis of this 29 yr old African American male show that he suffers from Axis I psychotic disorder as symptoms are relative to DSM – IV diagnosis. According to (ASA) “ The narrowest definition of psychotic is restricted to delusions or prominent hallucinations with the hallucinations occurring in the absence of insight into their pathological nature”(ASA 2002,pg.297).Joseph was having a pleasant outlook and this surprised the psychiatrist as it made him look less like a patient . However, he was claiming that people could read his thoughts. This is a sign of delusion where in patient assume that people are reading their thoughts and trying to harm them in some way. In psychotic disorder, at times people can look calm and may not project themselves to be a patient. They behave like a normal person and only when they converse about their experience clinician can identify the problem. Joseph had been reported saying that his upstairs neighbors read his thoughts and left negative comments like “You are no good!” and “Lisa wants nothing to do with you!” "Why don't you just leave!". According to DSM people suffering from psychotic disorder can suffer from delusion and feel like people are saying things related to him and they also feel to have supernatural powers. Joseph is reported to feel like have telepathic powers which is a sign of delusion and hallucination. .“ Delusions are false beliefs that significantly hinder a person's ability to function.  For example, believing that people are trying to hurt you when there is no evidence of this, or believing that you are somebody else, such as Jesus Christ or Cleopatra.  Hallucinations are false perceptions.  They can be visual, auditory, olfactory or tactile”(Heffner, 2002). According to DSM people with psychotic disorder suffer from abnormal thinking and perceptions. Joseph thinks that the people on the street could read his mind and understand the plans he had made for himself. He specifies that when he was in kitchen and planning the dinner menu, the person on the street already shouted the menu. When people suffer from psychotic problems they lose touch from the real world and assume things which are imaginary and delusive. Joseph had a past occurrence of psychological problem in college days where he received counseling for the same. This shows that he was susceptible to mental disorder and the major stress of unemployment triggered a psychotic situation in him. Joseph was very much distressed due to his loss of job and this brought out the mental disorder hidden in him. According to DSM psychotic disorder result in delusion and make patients feels that others are talking about them. “Psychosis can be intermittent or attenuated, or the patient may be unable to explain his or her experience in sufficient detail to help diagnosis”(Freudenreich, 2000 pg.18).Joseph went on to meet the criteria for psychotic disorder as he explained how he possessed telepathic ability. Clinician established that he is Axis I and a patient of psychotic disorder as Joseph explained how he heard people reciting dinner menu on the street. Clinician also have recorder a past history of Joseph with mental problem were he needed a counseling from psychiatrist.     Clinician could not assess anything on Axis II as Joseph showed only delusion and stress related problems and he was mild in his behavior. To establish the Axis II more observation and conversation with the patient was required. Psychotic disorder was established in the patient as to the Axis I diagnosis explained in DSM-IV patient can be at times mistakenly taken as suffering from schizophrenia as symptoms relate to it in a minor way.But in schizophrenia there can be seen a combination of symptoms which Joseph did not show. Regarding Axis III the clinician did not diagnose any disease related to nervous system or sensory organs.He never had any medical history related to damage of brain or other hereditary problems. In evaluating Axis IV the clinician find out that the main reason which brought about disorder in Joseph was his unemployment problem.Cleint had enormous stress due to losing job and showed abnormal behaviour and also had conflict with neighbors.In relation to Axis V the clinician categorized him within 21 – 30,which denotes that this behavior is influenced by delusion and hallucination. .Joseph has tried to be violent with neighbor and tried to break the door of neighbor with iron. And he is preoccupied with neighbors and imagining things of his own, like them being abusive to him. He does not think that he is having hallucination with regard to seeing people on the street and telepathic ability. Differential Diagnosis With regard to differential diagnosis, the symptoms of psychotic disorder and schizophrenia are similar in some way. Delusion and hallucination, irritated behavior is also signs of schizophrenia ands sometimes people can be misunderstood. “Schizophrenia is a challenging disorder that makes it difficult to distinguish between what is real and unreal, think clearly, manage emotions, and relate to others”(Smith 2010). Joseph shows no withdrawal from society or serious hallucination and can be categorized under any sub categories of psychotic disorders. Treatment Joseph is suffering with psychotic disorder and as a result he is experiencing visual and auditory hallucination. Joseph has to be treated with medication, which are antipsychotic drugs. Such medication can be respiridone, olanzapine, haloperidol and clozaril.Many types of psychotherapy are also available to the patient including individual and family therapy. (Fujii,2007,pg.62) “There is no clear treatment as in some cases, discontinuation of anticonvulsants has worsened and in other case, have improved psychosis”.Some people can be treated as outpatient but Joseph being in acute stage needs to be hospitalized and treated under the scrutiny of psychiatrist. The duration of treatment can be varied from days to months. How the patient reacts to medicine also varies from patient to patient. It can be possible that the disease runs in Joseph’s family and in that case medicine needs to be followed for longer duration. The clinician assessed that Joseph need medication and treatment to get back to normal life and have reasonable thinking ability Bibliography ASA, Initials. (2000). Diagnostic and statistical manual of mental disorders: dsm-iv-tr.. Airlington: R.R.Donnelley & Sons Company Freudenreich, O. (2008). Psychotic disorders: a practical guide . Philadelphia: Lippincott Williams & Wilkins. Fujii, D. (2007). The spectrum of psychotic disorders. Cambridge: Cambridge University Press. Heffner, Dr. (2002, September 23). Psychotic disorders. Retrieved from http://allpsych.com/disorders/psychotic/index.html Smith, M. (2010, November 12). Understanding schizophrenia. Retrieved from http://helpguide.org/mental/schizophrenia_symptom.html. Read More