ASSESSING AND DIAGNOSING PATIENTS WITH SUBSTANCE-RELATED AND ADDICTIVE DISORDERS

TO PREPARE:

· Review this week’s Learning Resources and consider the insights they provide.

· Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.

· By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.

· Consider what history would be necessary to collect from this patient.

· Consider what interview questions you would need to ask this patient.

· Identify at least three possible differential diagnoses for the patient.

BY DAY 7 OF WEEK 8

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.

Incorporate the following into your responses in the template:

· Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life? 

· Objective: What observations did you make during the psychiatric assessment?  

· Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.

· Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

DIFFERENT CASE STUDIES (SELECT ONE)

Select one of the following videos to use for your Assignment this week. Then, access the document “Case History Reports” and review the additional data about the patient in the specific video number you selected.

· Symptom Media. (Producer). (2017).  Training title 82  Links to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-82

· Symptom Media. (Producer). (2018).  Training title 114-2 Links to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-114-2

· Symptom Media. (Producer). (2018).  Training title 151 Links to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-151

USE THESE CASE HISTORIES TO SUPPLEMENT THE INFORMATION ABOUT THE PATINETS IN THE VIDEO CASE STUDIES.

Week 8 Substance-Related and Addictive Disorders Training Title 82 Name: Lisa Tremblay Gender: female Age: 33 years old T- 100.0 P- 108 R 20 180/110 Ht 5’6 Wt 146lbs Background: Lisa is in a Naples, FL detox facility thinking about long term rehab. She is considering treatment for her Hep C+ but needs to get clean first. She has been abusing opiates, approximately $100 daily. She admits to cannabis 1–2 times weekly (“I have a medical card”), and 1/2 gallon of vodka daily. She has past drug paraphernalia possession arrest. Her admission labs. abnormal for ALT 168 AST 200 ALK 250; bilirubin 2.5, albumin 3.0; her GGT is 59; UDS positive for opiates, THC. Positive for alcohol or other drugs. BAL .308; other labs within normal ranges. She reports sexual abuse as child ages 6-9 perpetrator being her father who went to prison for the abuse and drug charges. She is estranged from him. Mother lives in Maine, hx of agoraphobia and benzodiazepine abuse. Older brother has not contact with family in last 10 years, hx of opioid use. Sleeps 5-6 hrs., appetite decreased, prefers to get high instead of eating. Allergies: azithromycin Symptom Media. (Producer). (2017). Training title 82 [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa tch/training-title-82

Training Title 114 Name: Ally Chen Gender: female Age: 44 years old Background: Only child, raised by parents in Philadelphia, PA. Has PhD in biology and master’s degree in high school education (8–12). Her supervisor has asked the school EAP counselor to intervene with concerns regarding potential substance use in effort to facilitate getting her help and be able to retain her. She is divorced, has a 4-year-old son who lives with his father. Appetite healthy, sleeping 9 hours/24 hrs., wakes 2-3 times during the night. Denied drug use. had DUI when she was age 21.

Symptom Media. (Producer). (2018). Training title 114-2 [Video]. https://video-alexanderstreet- com.ezp.waldenulibrary.org/watch/training-title-114-2

Training Title 151 Name: Daniela Petrov Gender: female Age:47 years old T- 98.8 P- 84 R 20 B/P 132/90 Ht 5’8 Wt 128lbs Background: Moved to Everett, Washington from Russia with her parents when she was 16 years old. Currently lives in Boise, Idaho. She has younger 1 brother, 3 older sisters. Denied family mental health or substance use issues. No history of inpatient detox or rehab denied self-harm hx; Menses regular. uses condoms for birth control Has fibromyalgia. She works part time cashier at Save A Lot Grocery Store. Dropped out of high school in 10th grade. Sleeps 5-6 hours on average, appetite good. Symptom Media. (Producer). (2018). Training title 151 [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa tch/training-title-151