Discussion 1
INITIAL DIAGNOSTIC CASE €“ FOR PRACTICE
The purpose of this discussion is to make your first attempt at diagnosis of abnormal behavior, and to think through the processes involved. Read the brief Case Study of Edgar below. Then, using what you learned in your reading in this unit (u01s1 Study), identify the type of disorder that best describes Edgar’s behavior. Once you have selected a group of disorders, review the outline of that group of disorders in the DSM-5 Classification to identify the codes involved. (Make sure you have read the section on Depressive Disorders in the DSM-5.)
Case Study of Edgar
Edgar is 25 years old and was hospitalized today after a suicide attempt in which he drove his car into a lake. This is his first depressive episode. It started six months ago and is characterized by a nearly continual depression, loss of interest in all activities, an unplanned loss of twenty-five pounds, hypersomnia, an inability to concentrate and recurrent thoughts of killing himself. His mood state is severe, but there is no evidence of psychosis.
He began drinking five to eight beers per day in the last two months, clearly exacerbating his symptoms. Prior to the onset of these symptoms he consumed one to two beers per day. He uses no other drugs. Medical records indicate no medical conditions of concern. His marriage is in trouble due to his severe behavioral symptoms. His wife is thinking of leaving him; he was recently terminated from his job because he can’t get up to make it to work; and their house is in danger of being foreclosed on by the bank because he forgot to pay the mortgage for four months.
For your initial post in this discussion, address the following four aspects:
Record Edgar’s diagnosis or diagnoses as you see the issues in this case study. Do so in the following format.
Note: This is the essential format you will use for all diagnostics in this class:
DSM-5 Code number of disorder. ( ICD-10 number code, put in parentheses).
Name of the disorder detailed in the DSM-5.
Other Factors: What code numbers are needed to understand Edgar’s current concerns? What stressors may be involved?
You will want to consider “Other Conditions That May Be a Focus of Clinical Attention” starting on page 715 and summarized in the DSM-5 Classification section between pages xxxiv–xl.
Example (Realize that this example diagnosis may or may not be accurate; it is offered as an example of the format to use when you arrive at your own diagnostic view of the case of Edgar):
296.23 (F32.2) Major Depressive Disorder, Single Episode, Severe.
305.00 (F10.10) Alcohol Use Disorder.
Other Factors:
V61.10 (Z63.0) Relationship Distress with Spouse or Intimate Partner.
V62.29 (Z56.9) Problem related to Employment (job loss).
V60.9 (Z59.9) Potential loss of housing due to job loss.
Briefly describe the decision-making steps or process you used to arrive at your diagnosis or diagnoses of Edgar.
What did you find easy or difficult about this task at your current level of training in diagnostics?
What more you would like to know to ensure that you have coded Edgar’s diagnostic issues accurately?
Solution Preview
Disorder Diagnosis
296.23 (F32.2) Major Depressive disorder, single episode, severe without psychotic features
305.00 (F10.20) alcohol use disorder, severe
296.52(F31.32) bipolar I disorder
307.44 (F51.11) Hypersomnolence Disorder
307.53 (F98.21) feeding and eating disorder
Other Factors
V60.2 (Z59.6) economic problems, Low Income-inability to pay bills and mortgage
(892 words)