Case C: A 34 year old female married came to the clinic with the chief complain
ID: 137491 • Letter: C
Question
Case C: A 34 year old female married came to the clinic with the chief complain “ I cannot sleep when I do , I have bad dreams since last month. I feel restless.” Patient has normal weight and is in good health. She looks disorganized but dressed appropriate. She reported hearing voices since a week ago telling her she is worth nothing. She is having delusional thought about a black car parked in her neighbor’s house. she believes it is parked there to monitor her as reported by her husband. She presented with mild agitation and anxiety. She had prior hospitalization for severe agitation for psychosis a year ago. However, she denies suicidal thoughts. She stopped working because of disorganized about 8 months ago. Patient is obese, has family history of DM, History of noncompliance with medication.
Clinical Impressions: (Rationale for diagnosis and recommendations for services)
DSM-5 Diagnosis with list of diagnostic creterials:
Recommendations:
Labs:
Psychiatric Medications:
Drug: Dose/Schedule: Number/Refill: Fact Sheet Given Other
Rationale for each recommendation
Teaching
What would you include in a biopsychosocial treatment plan for the patient in addition to pharmacotherapy?
Explanation / Answer
*Biopsychosocial approach systematically considers biological,psychological and social factors and their complex interactions in understanding health,illness and health care delivery.
*Emphasis is placed on achieving positive health and functioning across the important areas of patient lives in addition to relieving psychological distress and reducing symptmatology.
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