Diagnostic and Statistical Manual of Mental Disorders

I would like to consider the case of Larissa and identify her diagnosis. To begin with, I will summarize the situation and highlight the client’s symptoms. Larissa is a 17-year-old Indian female who appeared in the emergency room because of cutting her right wrist following an argument with her parents. The most evident symptoms include difficulty doing homework, erratic behavior, sudden aggression, loss of interest in many activities that she liked, and suicidal attempts. In addition to that, Larissa has trouble sleeping and concentrating, while her mother reported that Larissa lost some weight without the help of diet or fasting. In addition to the current suicide ideation, the client has signs of previous cuts and cigarette burns on her body. Finally, the client stipulates that she frequently talks to a male presence that appeared after the funeral of her best friend, and this presence makes her behave violently and cut her wrists.

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I followed a thorough and systematic thinking process to determine the critical problems in the case and make differential eliminations. Thus, I wrote down the symptoms above, studied them, and referred to DSM-5 by the American Psychiatric Association (2013) to arrive at a diagnosis. The final decision is made based on diagnostic criteria and symptoms that were highlighted in DSM-5. In particular, my task was to identify the health condition that could justify Larissa’s mental and behavioral issues. It is not a surprise that I initially developed a few diagnoses, but the work with DSM-5 allowed me to eliminate some of them. On the one hand, I excluded bipolar disorder because the case does not stipulate that the client has increased energy and activity episodes. On the other hand, schizophrenia was eliminated because spontaneous assault and violence are uncommon for this condition.

Based on the information above, I identified that Larissa’s diagnosis is Major Depressive Disorder. According to DSM-5, this diagnosis is made when a person has a few symptoms, including diminished interest in everyday activities, significant weight loss, sleep issues, difficulty concentrating, suicide ideation, psychomotor agitation, and depressed mood (American Psychiatric Association, 2013). When it comes to adolescents, they typically suffer from irritable rather than depressed moods (American Psychiatric Association, 2013). In addition to that, Larissa has hallucinations of a male presence, while unconfirmed statements of family abuse and sexual violence can be considered delusions.

Now, it is possible to use the collected data to identify the diagnosis. For Larissa, it is F33.3 Major Depressive Disorder, recurrent episode, with mood-congruent psychotic features. Simultaneously, Z55.9 Academic or Educational Problem and Z62.820 Parent-Child Relational Problem can be a focus of clinical attention.

Schizophrenia is a challenging medical condition that adversely affects people’s lives. The given assignment focuses on the case of Cecilia McGough. The video by TEDx Talks (2017) presents her experiences with schizophrenia. McGough stipulates that she had probably had this medical condition since her childhood. However, its onset occurred during her first year of high school, while the symptoms became the most evident when she was in college. Hallucinations were the most apparent symptom that McGough witnessed. In particular, she saw a clown, spiders, and a girl from a horror movie. The hallucinations were so acute that Cecilia could not concentrate and do her homework. As a result, she made a suicide attempt, and it took eight months to get the proper treatment. However, the condition taught the woman to find positive moments, and she currently relies on humor to manage the illness. McGough learned how to live with the diagnosis and created a non-profit organization to empower students with schizophrenia.

As a social worker, I would rely on specific diagnostic measures to confirm the diagnosis. DSM-5 stipulates that the Clinician-Rated Dimensions of Psychosis Symptom Severity and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) (American Psychiatric Association, 2013). As for the first instrument, I would complete it by myself by rating the severity of eight symptoms in the patient. Simultaneously, I would ask the client to complete the 36-item WHODAS 2.0. The combination of these two measures would allow me to obtain a comprehensive picture of the patient’s condition. On the one hand, the WHODAS 2.0 would demonstrate the client’s attitudes toward her condition. On the other hand, the Clinician-Rated Dimensions of Psychosis Symptom Severity would help me professionally assess and synthesize the health conditions.

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Now, it is reasonable to comment on what treatment options are suitable for McGough. Firstly, specific medication is a helpful long-term solution for people with schizophrenia (Walsh et al., 2016). Cecilia McGough admitted that she positively responded to appropriate medications. That is why it is possible to rely on this treatment option to help the person manage her condition. However, individualization measures are necessary to ensure that medical treatment does not bring side effects that prevent McGough from normal functioning (Walsh et al., 2016). Secondly, McGough demonstrated that she relied on humor to cope with the condition. That is why it is rational to make her attend humor skills training because this intervention leads to a decrease of negative symptoms (Atadokht et al., 2019). Finally, since McGough is highly interested in scientific activity and running her non-profit organization, an appropriate treatment plan can be to highlight the fact that schizophrenia symptoms can deprive her of these activities (Cohen et al., 2017). The combination of these three options can contribute to optimal health outcomes for Cecilia McGough.

Numerous social work researchers and practitioners mention that the illness can result in a few challenges for people living with it, and it is reasonable to identify them. Firstly, when individuals become aware of their diagnosis, many of them start feeling shame and loss. These people feel ashamed for being a burden for their families and lose hope to have a normal life (Walsh et al., 2016). Secondly, people with schizophrenia have some issues regarding interpersonal relationships. On the one hand, some of them stipulate that friends or even relatives can break off the relationship because of the identified diagnosis (Walsh et al., 2016). On the other hand, individuals with the illness report having difficulties establishing new contacts. The reasoning behind this challenge is that people with schizophrenia are fearful that others will consider them abnormal or psychotic (Walsh et al., 2016). These are the leading issues, meaning that affected people can witness many other challenges.

When a person is diagnosed with schizophrenia, it is essential that they are not left by the whole world, denoting that social, family, vocational, and medical supports are necessary to manage the condition. Walsh et al. (2016) highlight the importance of a social sphere because the support of friends and helping other people with schizophrenia typically results in improved health outcomes. There is no doubt that family also plays a significant role, but White and Unruh (2013) mention that mothers of children with schizophrenia require occupational assistance to get adequate jobs and support their children. Simultaneously, Cohen et al. (2017) admit that those people with the illness who have an occupation typically show better results. That is why there is robust reasoning behind promoting specific vocational training for such individuals. Finally, many scientific studies highlight the importance of medical treatment to help people manage their schizophrenia conditions (Cohen et al., 2017; Walsh et al., 2016). If all these supports are present, people with the diagnosis will have sufficient resources to mitigate the condition’s negative symptoms.

In conclusion, it is necessary to comment on the fact that personal characteristic features can influence an individual’s experience with schizophrenia. For example, the USA is a multinational country that is home to millions of immigrants, meaning that representatives of various races or ethnicities can feel the burden of the illness differently. On the one hand, a study by Hernandez et al. (2013) focused on Latino families with one member with schizophrenia living in the United States. This article identified that an increased hope for the patient’s future was associated with their improved empowerment in society (Hernandez et al., 2013). The reasoning behind this state of affairs is that “providing support to family members is highly valued in Latino culture” (Hernandez et al., 2013). On the other hand, Kung (2016) considered Chinese Americans and found that the experiences of those individuals were worse. In particular, representatives of this immigrant group typically had insufficient knowledge of the language and, consequently, community resources to achieve the necessary support (Kung, 2016). This information denotes that a person’s origin can determine how they can manage schizophrenia.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Pub Inc.

Atadokht, A., Ebrahimzadeh, S., & Mikaeeli, N. (2019). The effectiveness of humor skills training on positive and negative symptoms of chronic schizophrenia spectrum. Journal of Holistic Nursing and Midwifery, 29(1), 15-21. Web.

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Cohen, A. N., Hamilton, A. B., Saks, E. R., Glover, D. L., Glynn, S. M., Brekke, J. S., & Marder, S. R. (2017). How occupationally high-achieving individuals with a diagnosis of schizophrenia manage their symptoms. Psychiatric Services, 68(4), 324-329. Web.

Hernandez, M., Barrio, C., & Yamada, A.-M. (2013). Hope and burden among Latino families of adults with schizophrenia. Family Process, 52(4), 697-708. Web.

Kung, W. (2016). Tangible needs and external stressors faced by Chinese American families with a member having schizophrenia. Social Work Research, 40(1), 53-63. Web.

TEDx Talks. (2017). I am not a monster: Schizophrenia [Video]. Web.

Walsh, J., Hochbrueckner, R., Corcoran, J., & Spence, R. (2016). The lived experience of schizophrenia: A systematic review and meta-synthesis. Social Work in Mental Health, 14(6), 607-624. Web.

White, C., & Unruh, A. (2013). Unheard voices: Mothers of adult children with schizophrenia speak up. Canadian Journal of Community Mental Health, 32(3), 109-120. Web.

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