The Trustworthiness of Patients Disordering - Case Study Example

Insert your name here] [Insert professor’s name here] [Title of the course] [Date of submission] Identifying information The patients name is Amy S. and she is twenty seven years of age. Source – Self (self volition) Reliability The patient though experiencing some psychiatric disorder, an illness that interferes with the way a person behaves, interacts with others, and functions in daily life (health.bettermedicine.com), she still has insight. It is therefore in order to say that from the examination and collection of history, she is very reliable. The following words from the patient are able to concretize my conclusion. First and foremost, the patient knows clearly why she has come to see the doctor. She knows that she has a rash on back of left and right hands. This rash that she first noticed two months has been getting worse instead of better. Lastly, she knows that though the skin is red and dry, she neither has lumps, bumps, excoriations nor wounds. She can vividly remember she had a similar rash in high school. And this rush according to the name give was called atopic dermatitis. During this period, she used a cream that made the rush disappear. The patient can also help trace her family’s medical history. Beginning with her mother, she says that the mother had depression and had to depend on medication throughout her life but no history of psychiatric disorder from the mother she could remember. And lastly, the patient admits that her habit of washing hands more often is a problem for her husband and do not know how to help it. She can give information on how their relationship has been constrained because their sex life has not been the same especially after the birth of their daughter. Chief Complaint: “I have a rash on back of my hands for two months and it is getting worse” History of the Present Illness (HPI) Tracing the last time the patient was doing well, she explains that she first noticed the rash on back of left and right hands two months ago. However, she adds that she had similar rash in high school. Going by the data, apparently, the patient must have been doing well before joining high school. History of the current disorder traces back from her mother. She explains that her mother had history of depression which was on and off. This condition which was hard dealing with when she was growing up, forced her mother to be in medication her whole life. On the other hand, she explains that her paternal grandfather had psychiatric disorder because he used to collect what she called “a lot of junk in his stuff” and this led to what she described as “can’t get through the room” as a result of these behaviors, the patient explains that her grandfather was almost kicked out of his house. And any effort made by the family to avert the condition was futile because she explains that, “he resisted psychological treatment.” And from the record, the patient, the paternal and maternal relatives had no history of substance use. As a long outstanding diagnosis, the patient has a mild psychiatric disorder. The development of all the psychiatric symptoms and behaviors that support my diagnoses are due the facts that she washes her hands 25-30 times in a single day. Another behavior related to the condition is that she now uses diluted bleach to wash hands and in doing so, she feels that it is working better. She thinks that she feels relaxed after washing hands, but this does not make her feel “clean and satisfied” is another psychiatric symptoms. Lastly, there are some nights she recounted getting out of bed to wash her hands even though the husband asked to stop. Mentioning precipitating events, the patient has no intimacy with the husband because her concerns are elsewhere. This and rash on back of left and right hands of her hands has got the patient to seek treatment in order to avoid risk of violence with the husband. Past Psychiatric History (PPH) The lifetime history of the disorder is the initial symptoms such as the atopic dermatitis she first noticed in high school. The prior treatment for the infection was the use of cream which made it go away. Basically, symptom for the current psychiatric disorder is the rash the patient believes are caused by germs found in her hands. To remove the germs, she keeps washing her hands often. From the history though, the patient has no other psychiatric disorders that may have resolved. Focused Medical History Analyzing focused medical history, current illnesses of the patient range from rash that found on the back of both left and right hands to dry and red skin. When she first experienced the rashes, she went for medications and a cream was given to that effect. This medication did not make the patient to have allergies of any type. In fact, she denied having congestion and sneezing. Before, the rashes, the patient did not record any serious illness or surgeries other than being hospitalized when she was delivering. Basing on the reproductive history, the patient gave birth to her daughter two months ago and named her Nora. There were no pertinent negatives from the patient such as head injury. Family Psychiatric History The patient’s first-degree relative hard no mental illness, suicides or substance abuse. She grew up with one brother and a sister who she cannot remember suffering from mental illness. Her father too had not registered any sign of mental problem. However, the patient admits that her mother had history of depression which was on and off with medication. The history of her immediate family does not account anybody using drugs or any other related substances. Moving to second-degree relatives, her mother’s parents had no any psychological issues she could remember of. On contrary, her paternal grandfather used to do what she call, “collects a lot of junk in his stuff” and resisted psychological treatment. On the other hand, her paternal grandfather had no any record of psychological issues. And generally, the patient’s family history had no asthma, heart attack, cholesterol, thyroid, or drug related complications because even the paternal grandfather just died of colon cancer. Social/Development History Considering her parents, the patient explains that they had good relationship by describing it as, “pretty happy family.” She confessed that the parents got along well with community and coworkers. This case was similar when we look at her relationship with the parents. She admits that she loved her mother was her huge inspiration. But also quick to point out that her mom, “wasn’t always fully present as a mom” even if she wanted to be. The patient though had little difficulty in college. She was teased by her suite mates for how much long she cleaned their room and suite. Her marriage life seems to be stable and amazing as she refers to her husband as “wonderful dad” who has been a “wonderful husband” despite the financial crisis. Mental Status Examination She was clearly oriented to time place and date etc The patient could spell DLROW correctly. Able to explain “people who lives in glass houses should not throw stones” in detail and abstract way. Was able to repeat and perform the task “uncross your legs” Was able to add 3 +5 Was able to recount the last three presidents. For instance, she knew Obama and G HW B and the first president of United States. However, she was aware who Clinton was. Attitude towards interview The patient was positive and welcoming. Speech Speech was clear as she could even pronounce words such as DLROW correctly Thought process Clear thought process since names such as Obama and G HW B were well integrated. Suicidal/Assaultive thoughts, plans or intentions. The patient has not thought or planned for suicide before. She takes the condition positively. Affect The patient showed appropriate affect. Work cited http://health.bettermedicine.com/article/psychiatric-disorders Read More