For the vignette, please give a diagnosis and bullet point t…

For the vignette, please give a diagnosis and bullet point the symptoms that made you come to the diagnosis. A 28-year-old graduate student states that he has his ‘ups and downs.’ Further questioning reveals that at times over the past 2 years, he has had episodes of extreme happiness in which he would party every day and felt as if he was ‘full of energy.; He also describes being ‘down in the dumps’ at times for no apparent reason. He has never been hospitalized for psychiatric reasons, nor has he had suicidal thoughts or attempted to commit suicide.

For the vignette, please give a diagnosis and bullet point t…

For the vignette, please give a diagnosis and bullet point the symptoms that made you come to the diagnosis. Kathy is a 32-year-old female who has had 17 prior admissions to acute care psychiatric facilities for suicide attempts and self-mutilation. She reported hearing voices and losing periods of time for which she could not account. She had alcoholic parents who exhibited violence toward each other and Kathy. They divorced when Kathy was 5 and she lived with her mother and a series of “stepfathers” who physically and sexually abused her. She was first hospitalized at age 13 following a Tylenol overdose. Shortly thereafter she refused to go to school and lived on the streets where she traded sex for food and shelter. Kathy was picked up by the juvenile authorities and spent the next 4 years in a residential program as a ward of the state. Her behavior improved with the structure; she completed high school and got a secretarial job. She married at age 20, but her husband reported that she was extremely moody and would often become hysterical during sex. Kathy began having “flashbacks” of sexual abuse and became extremely depressed. She was hospitalized repeatedly during the next 10 years receiving diagnoses of schizo-affective disorder, bipolar mood disorder and borderline personality disorder. Kathy had seen her current therapist for 6 months at the time of admission. A clinical interview revealed that Kathy often heard “mean voices in her head” and “children crying.” Kathy reported that she cut on her arms and abdomen to “relieve the internal pressure and stop the bad feelings.” Kathy said she frequently lost periods of time and would find herself in strange places not remembering how she got there. Upon request, the therapist was able to talk to an alter personality, Julie, who said that she helped Kathy during times of stress.

Dave is a 41-year-old male who was referred by his primary c…

Dave is a 41-year-old male who was referred by his primary care physician after presenting to the ER with difficulty breathing. Dave’s physician was unable to find a medical explanation for his symptoms, which left Dave feeling confused, stressed, and angry. Over the last 6 months, Dave has had several instances where he felt an intense fear that would reach a peak within a few minutes. During these instances, he would also experience sweating, heart palpitations, chest pain and discomfort, and shortness of breath. At times, Dave worried that might die. As a result, Dave has persistent worry about having another attack. In addition, he has begun to avoid unfamiliar places and people where it may be difficult to get help in the event of another episode. The avoidance is significantly impacting Dave’s life as he has been turning down social invitations, making excuses to stay at home whenever possible, and relying on his wife to drive their children to their various activities. Although she was understanding at first, Dave’s wife has grown frustrated with what she perceives as an irrational fear. (Hint: Dave has 2 disorders)