Case 3A Ella

The client has been diagnosed as 297.1 (F22) Delusional Disorder with subtype Erotomania; this is defined as having a number of delusional states which involve real life situations; this delusional states occur for more than one month within the affected. The client reports that she had left her previous loveless relationship with her previous husband in Florida to marry Mr. Bennett. Investigating the client’s family in Florida, it is revealed that Rosa had expressed a mutual relationship between her and Mr. Bennett. The client did not report any symptoms of anxiety or depression when brought to the inpatient unit. Therefore she did not have schizophrenic outbursts. Her cooperative behaviour shows that the client did not have any bizarre mood swings. The client expressed details about how she and Mr. Bennett have maintained a consistent distant relationship for the last three years. Physical examination revealed that the client had a delusion of being pregnant with Mr. Bennett’s child. This shows that the client reports are consistent with the diagnostic criteria A, B, C, D, E (Arlington, 2013). Other conditions requiring a focus are V62.29 (256.9) Other Problems related to Employment. This may be due to the client being fired by her boss, Mr. Bennett.

312.31 (F63.0) Gambling Disorder

V60.3 (Z60.2) Problem Related to Living Alone

V62.82 (Z63.4) Uncomplicated Bereavement

V62.89 (Z60.0) Phase of Life Problems

The client has been diagnosed with 312.31 (F63.0) Gambling Disorder. This underlies a total of ten criteria which determines the level of disorder progression. The client Edna reports that she feels excitement about her casino trips and that she loved to win money by setting a higher limit in comparison to her previous casino wins. She expresses huge excitement while discussing about her biweekly casino trips. However, her expression becomes dull while discussing about her children. She tends to lie before her children for her gambling, although she does not like lying to her children. She further reports that she worries about how to spend her time without a work life, she therefore does not prefer to take retirement in this worry. She reports that her children continue to stay separated, therefore she does not like loneliness. She prefers to work during her loneliness. The client meets diagnostic criteria 1, 2, 4, 5, 6, 7, 8, 9, 10. She does not meet the criteria for differential diagnosis related to other mental or personality disorders (Jongsma, Peterson & Bruce, 2014). She reported irritability due to cancellation of any casino trip. Other conditions that require attention are V62.89 (Z60.0) Phase of Life Problems; this may be due to her difficult life phases during her transition from a complete motherhood to an empty house when she feels loneliness. V62.82 (Z63.4) Uncomplicated Bereavement and V60.3 (Z60.2) Problem Related to Living Alone also require focus.

300.01 (F41.0) panic disorder

292.21 (F32.0) Major Depressive Disorder, mild

V61.20 (Z62.820) Parent-Child Relational Problem

V61.29 (Z62.898) Child Affected by Parent Relationship Distress

The client has been diagnosed with 300.01 (F41.0) Panic Disorder which means that the client has frequent panic attacks due to fear and discomfort reaching to higher levels. The client reports that she suffers from fast heartbeat, chest discomfort, dizziness and she has a fear of losing control. The client further reports that she suffers from a persistent fear that she might develop panic attacks when around her friends. She also reports of her distressed behaviour when her dog was bitten by her father. She reports that her panic attacks last for two minutes, however, it seems to her as if those symptoms have been continuing for long hours. She reports that she suffered extreme turmoil due to her parents’ arguments amongst them. The client expresses guilt because of her presence within the family. She reports that she feels extremely sad all throughout the day. The client meets the diagnostic criteria A 1, 4, 5, 6, 8, 12; B 1, 2; C and D. The client does not meet the criteria for differential diagnosis of personality changes, behavioral changes, and psychosocial trauma.

 The client is also diagnosed with 292.21 (F32.0) Major Depressive Disorder, mild; she suffers from depressing episodes during the entire day. She even suffers from difficulty to sleep. A feeling of worthlessness has been reported by the client. The client expresses guilt of her presence and that her presence is a cause of her parents’ divorce in life. She reports that a recurrent thought The client meets the diagnostic criteria A, Ba, Bb, Bc, Ca, Cb, Cf. The client does not meet the criteria of differential diagnosis for major depression disorder, stress conditions. Other conditions that need attention are V61.20 (Z62.820) Parent-Child Relational Problem and -V61.29 (Z62.898) Child Affected by Parental Relationship Distress. This is possibly due to her distressing mental conditions as a result of her parents’ divorce. She faces relational disturbances with her parents.

References:

Arlington, VA. (2013). American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th edition).

Jongsma, A. E., Peterson, L. M., & Bruce, T. J. (2014). The complete adult psychotherapy treatment planner. Hoboken, NJ: Wiley& Sons, Inc.