Jose is a Latino client who presents with occupational difficulties. He was laid

Question

Jose is a Latino client who presents with occupational difficulties. He was laid off from a construction job 8 months ago and has been unable to find work. Ever since he lost his job, he has been drinking alcohol heavily throughout the day. he also reports occasional marijuana use. Jose recently was arrested for driving under the influence of alcohol and has to appear in court next month. His wife is angry with him because she depends on him to pick up their 3 children from school, and now he may lose his driver's license. Jose has always been a hard worker but he admits that there were times that he often drank alcohol while working on construction jobs to eliminate his stress. He reports having intermittent episodes of anxiety since adolescence. Jose should be diagnosed with F43.22 Adjustment disorder with mixed anxiety and depressed mood?

Explanation / Answer

For diagnosing Jose as having Adjustment disorder with mixed anxiety and depressed mood, his symptoms should meet the criteria for disorder as stated in Diagnostic and Statistical Manual (DSM) published by American Psychiatric Association. DSMs are used as a standard for diagnosing mental disorders. The symptoms should include [1]:

Other mental symptoms of adjustment disorders (depending on the type of adjustment disorder) can include [1]:

For a person to be diagnosed with Adjustment disorder with mixed anxiety and depressed mood, she/he should show both the symptoms of anxiety as well as depression. The adjustment problem has started due to getting laid off from job (reaction to life changing event). Jose has to be evaluated to see if he has had more than one episodes of depressive episodes for at least 2 weeks (most of the day or nearly every day). These symptoms should not be due to grief, medication, substance abuse, etc. Episode should include 5 or more symptoms from [1]:

If Jose qualifies to these depressive symptoms then he can be diagnosed with Adjustment disorder with mixed anxiety and depressed mood. Otherwise he will be just diagnosed as Adjustment disorder with anxiety.

REFERENCES:

[1] - American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC

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