Author: Anonymous

Find the diagnosis for Kenny: include all numbers, subtypes…

Find the diagnosis for Kenny: include all numbers, subtypes and specifiers 4 points Kenny a 45-year-old Caucasian male, who had been referred by his family physician, presented at the office with his wife of 20 years, Kathy, and their two teenage daughters Susie and Rachel. The wife reported Kenny had been threatening to kill himself, and that he had lost 10 pounds in the past month. Kenny explained that he felt worthless because he could not hold down a job and was causing his family too much stress. Further discussion revealed that the family had moved from Delaware to Kansas so that Kenny could take a job in the Department of Housing, but he had been fired after less than 6 months of employment.According to Kenny, he was able to get a job but could not keep it because of “his problems.” He described his problems as, “worrying about everything and not being able to relax.” When prompted to disclose more information about what he was worrying about, he explained that everything was always such a mess, and he was always left cleaning and securing things. Kenny disclosed that he constantly had to check and recheck everything after his family. He reported having to make sure that the house was secure and often locked and relocked the door just to verify that it had been done correctly. Kenny also reported that he could not get up out of bed until the entire family was dressed and ready to leave the house. He then had to clean the bathrooms, bedrooms, and kitchen which family members had used. The family was only allowed to sit in the living room and watch television while he did this. Kenny reported how this could be extremely frustrating. For example, just yesterday after the rooms had been cleaned his daughter had to go back and use the bathroom. This meant that Kenny had to re-clean the bathroom and retrace her path from the living room to the bathroom to ensure it was cleaned. Once all the rooms were cleaned and checked, except for the living room, the family moved outside to wait for him. Kenny then cleaned and made sure the living room was also ready. He then proceeded outside and allowed the family to sit in the car while he locked and relocked the front door.Afterward, he joined his family in the car and once seated he reviewed the contents of the car. When he was satisfied that things were in place, he would put his hand cream on his hands and wait for it to dry before he would turn the car’s ignition to start. Only if this routine was fully followed could he allow himself to pull out of the driveway. He also described how on this morning when he pulled out of the driveway, he noticed a piece of litter on the curb. He pulled back into the driveway, picked up the litter and went into the house to throw it away. Therefore, he had to clean his pathway in the kitchen and lock and relock the front door again. Variations in his routine are not well tolerated. This process took over three hours and was described as a typical example of what it took for the family to leave the house.When asked about his childhood, Kenny reported that he could remember washing and rewashing his hands and clothes numerous times a day as early as eight years old. He stated that he began to organize his closet after watching a movie on military training postulated that each hanger in his closet should always be exactly one inch apart. While growing up he realized that other children were not doing things to the extreme he was, so he tried to stop. He stated he was unable to stop his behavior, so he worked on hiding them from others to avoid being teased.