When Ernest Eaton’s desperate wife finally got him to agree to a comprehensive inpatient evaluation, he was 37, was unemployed, and had been essentially nonfunctional for several years. After a week during which he was partying all night and shopping all day, Mrs. Eaton said that she would leave him if he did not check into a psychiatric hospital. The admitting psychiatrist found him to be a fast-talking, jovial, seductive man with no evidence of delusions or hallucinations.
Mr. Eaton’s troubles began 7 years before when he was working as an insurance adjuster and had a few months of mild, intermittent, depressive symptoms, anxiety, fatigue, insomnia, and loss of appetite. At the time, he attributed these symptoms to stress at work, and within a few months was back to his usual self.
A few years later an asymptomatic thyroid mass was noted during a routine physical exam. One month after removal of the mass, a papillary cyst, Mr. Eaton noted dramatic mood changes. Twenty-five days of remarkable energy, hyperactivity, and euphoria were followed by 5 days of depression during which he slept a lot and felt that he could hardly move. This pattern of alternating periods of elation and depression, apparently with few “normal” days, repeated itself continuously over the following years.
During his energetic periods, Mr. Eaton was optimistic and self-confident, but short tempered and easily irritated. His judgment at work was erratic. He spent large sums of money on unnecessary and, for him, uncharacteristic purchases, such as a high-priced stereo system and several Doberman pinchers. He also had several impulsive sexual flings. During his depressed periods, he often stayed in bed all day because of fatigue, lack of motivation, and depressed mood. He felt guilty about the irresponsibilities and excesses of the previous several weeks. He stopped eating, bathing, and shaving. After several days of this withdrawal, Mr. Eaton would rise from bed one morning feeling better and, within 2 days, be back at work, often working feverishly, though ineffectively, to catch up on work he had let slide during his depressed periods.
Although both he and his wife denied any drug use, other than drinking binges during his “active” periods, Mr. Eaton had been dismissed from his job 5 years previously because his supervisor was convinced that his overactivity must be due to drug use. His wife had supported him since then.
When he finally agreed to a psychotic evaluation two years ago, Mr. Eaton was minimally cooperative and noncompliant with several medications that were prescribed. His mood swings has continued with few interruptions up to the current hospitalization.
In the hospital results of his physical examination, blood chemistry, blood counts, computed tomography scan, and cognitive testing were unremarkable. Thyroid function testing revealed some laboratory evidence of thyroid hypofunction, but he was without clinical signs of thyroid disease. After a week he switched to his characteristic depressive state.
Mr. Eaton is the oldest of three children. His father owned a convenience store in the small town where Mr. Eaton was raised. When he was younger, his mother helped run the store. However, she started staying home, and at times, wouldn’t get out of bed. His father had to put her in the hospital a couple of times because she would stay in bed and cry. Eventually, she started going to therapy and taking medication and was “better” over time. His parents raised them in a home where problems weren’t discussed, so they never explained what was wrong with his mother.
The cases take us out of the classroom and into the lives of real people. How does a particular disorder come to exist for a particular person? What is it like to live with these disorders? What help is available? The goal of these cases is to help apply the information you read in the text so that you can gain insight, understanding, and empathy.
You are to complete a total of 3 case analyses. You will find the cases listed under the week they are due. You will also find a sample case and case analysis illustrating how the case analysis is to be done.
Your book does not present all the criteria for most disorders completely. It is best to use the website www.behavenet.com and other webistes to make sure your list of criteria is complete. However, some of the disorders were changed from the DSM-IV-Tr to the DSM-5 and behavenet has not updated the criteria. Therefore, whatever website you use, make sure it indicates that is the DSM-5 criteria. Use your textbook to provide additional information when necessary and for etiology and treatment.
Your case analysis should follow this format:
1. Diagnostic Impression – Complete an impression for diagnosis and stressors (previously Axis IV in DSM-IV-Tr). Review the documents labeled “Explanation of Diagnostic Impression” and “Sample Case Analysis” (4 points)
2. Diagnostic Criteria – Diagnose and then list in the table all the DSM-5 criteria for that particular disorder. You may cut and paste the criteria from www.behavenet.com. The link is posted on Moodle. It is very important that each symptom is individually listed in a cell by itself like the sample case (4 points).
3. Symptoms – Identify the symptoms the person is experiencing in the case as they apply to the criteria; list specific examples from the case to illustrate a particular symptom (6 points).
4. Etiology – From your textbook, identify the major explanations offered for the origins of that disorder. This should include developmental (age) and gender as well as the other “causes” (not clinical profile/symptoms) listed in the book. Then, from the case, identify the evidence that applies to each of those explanations. List all causes even if it doesn’t apply. If it doesn’t apply, then indicate that it does not apply to the case. (4 points)
5. Treatment – From your textbook, list all treatments for this disorder and which treatments, if any, are the most effective. If a treatment was used, identify what it was, and, if applicable, note its effectiveness in this particular case. If it was not used, then indicate that the particular treatment was not used. (4 points)
6. Differential Diagnosis – below the table, in paragraph form, include two other diagnoses you considered for the case, what made you think of each of those disorders (i.e., what symptoms was the person experiencing that supported that disorder), and why you didn’t eventually select that particular diagnosis. This last point should be illustrated through what the person is experiencing that is not explained by the disorder being discussed (6 points)
7. Grammar, spelling, etc. (2 point).
With the exception of 1 and 6 above, it is important to format it in a table just like the sample. A template has been provided. Each criterion/symptom should get an individual row and then the corresponding symptoms the person is experiencing should be in the column next to it – just like the example. This allows me to see your understanding of the symptom/cause/treatment and your application to the case. The assignment WILL NOT be accepted if it is not in table format.
Other than listing the criteria, you cannot write straight from your textbook. The information is for you to read and understand and then paraphrase. In addition, you are likely to consult with a classmate, but your analyses CANNOT be identical to another’s work. If there is any suspicion of plagiarism, including copying from classmates, then the grade will result in a zero on the assignment, at minimum, or an F in the course for all parties involved.
You must use Microsoft Word only.
APA
CLICK HERE FOR FURTHER ASSISTANCE ON THIS ASSIGNMENT
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