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Case 14 - Generically Speaking, Generics are Adequate

Published online by Cambridge University Press:  19 October 2021

Stephen M. Stahl
Affiliation:
Neuroscience Education Institute
Thomas L. Schwartz
Affiliation:
SUNY Upstate Medical University
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Summary

Patient evaluation on intake

• Patient #1

  • – 60-year-old man with a chief complaint of “being angry and down”

• Patient #2

  • – 15-year-old girl with a chief complaint of “everything sucks”

• Patient #1 states that he was involved in a fracas at work, was pushed down the stairs, and was in a coma for a week

• Patient #2 states that she has been having a difficult time at home and at school

Psychiatric history

• Patient #1 had been without any psychiatric issues until his head injury. He states his symptoms developed after this

• Patient #2 states that she has gradually become more emotionally labile, depressed, and anxious over the last one to two years

• Patient #1 has not been able to go back to work at all due to his depression, amotivation, and anger management problems

• Patient #2 has been absent from school due to her inability to get up and get ready for school

• Patient #1 admits to full syndrome MDD

  • – He has passive suicidal thoughts that there is “not much to life” and he “wouldn’t mind if he didn’t wake up”

  • – Admits to poor focus, concentration, and amotivation as chief Complaints

• He states that little things make him angry quickly

  • – Experiences road rage and followed fellow drivers after Incidents

• He states that he was never like this prior to his accident

  • – Denies PTSD-related avoidance, flashbacks, or nightmares as he does not remember the accident due to his head injury and coma

  • – Is tense and hyperaroused most of the time

• He has relatively few friends as most were colleagues at his previous job. He is at home more and not motivated to leave his home

• Patient #2 admits to full MDD symptoms

  • – Has suicidal thoughts that occur more when stressed

  • – Admits to having an inability to focus, poor concentration, and lack of enjoyment as chief complaints

• She states that “little things make her angry quickly”

  • – She is afraid that going to school puts her in situations where she may strike out and get into fights, even though this has never been her social pattern

  • – She has friends but feels disenfranchised from them

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2016

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