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Final Project: Case of Hermosa
Anthony Welsh
Masters of Social Work Walden University
SOCW 6090: Psychopathology for Social Work
Dr. Peggy Morrison
May 09, 2021
Final Project: Case of Hermosa
Diagnosis
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F32.3 Major Depressive Disorder with mood congruent psychotic features
F43.10 Post Traumatic Stress Disorder, severe
Z63.4 Uncomplicated Bereavement
Z91.410 Personal History (past) of spouse violence, Physical
Z91.410 Personal History (past) of spouse violence, Sexual
Z91.411 Personal History (past) of spouse violence, Psychological
Z91.5 Personal History of Self-Harm
Demographics and Presenting Problem
Hermosa is a 43 year old Hispanic Female, divorced and widowed, with 2 biological children
and 2 step-children. Hermosa also has a brother and sister within 2 hours and her parents within
4 hours of her home. In April 2020, Hermosa voluntarily checked into the emergency room due
to depression that has been present and worsening since the sudden passing of her second
husband in December 2018. Client admits dysphoria, auditory hallucinations, uncontrolled
crying and suicidal thoughts in the recent past. Client has psychiatric history from 2001-2003
with unknown professional and has been seen by Dr. W since June of 2019. Client is currently
taking Prozac and Seroquel as prescribed.
Diagnosis Explained
Major Depressive Disorder diagnosis criteria was met in Criteria A sections 1,2,4,7,8,9 as
well as Criteria B, C, D, E (American Psychiatric Association, 2013)
Criteria A1- Client states that she is in a depressed mood most of the day
A2- Client stated they weren’t finding interest in things any longer
A4- Client stated difficulty falling asleep most nights
A7- Client states she doesn’t feel like she should be here anymore
A8- Client admits to having an inability to concentrate
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A9- Client admits to suicidal thoughts without plan and past attempt
B,C,D,E,- Client does not socialize and is fearful of meeting new people. Client
denies any substance use. No other diagnosis better explains the major depressive
episode. No history of mania
Specifier of with mood congruent psychotic features is due to auditory
hallucinations client admits to having of two men on her shoulders telling her self-
depreciating things.
Post-Traumatic Stress Disorder diagnostic criteria was met in Criteria A1, B2,3,5, C2,
D2,5,E4,5,6, F,G,H
Criteria A1- Client directly experienced Trauma during abusive 1
st
marriage
B2,3,5- Client admits to recurrent memories, dissociative and physiological
reactions to triggers.
C2-Client admits to avoiding external reminders
D2,5-Client admits to negative self-thought and diminished interest in things
E4,5,6- Client admits to exaggerated startle response, difficulty concentrating and
falling asleep
F,G,H-Duration is reported over 1 month in length, disturbance impairs clients
social relationships and is not substance related.
Differential Diagnoses
Differential diagnoses considered were, Schizophrenia, Bipolar 1, and Persistent
Depressive Disorder. Schizophrenia was not met due to hallucinations not being regular and
significant portion of time. Bipolar 1 was disqualified due to the lack of mania in the clients
psychiatric history and statements of family. Persistent Depressive Disorder could not be met