1. Diagnosis and treatment: He is having trouble with school and in relationship
ID: 80683 • Letter: 1
Question
1. Diagnosis and treatment:
He is having trouble with school and in relationship. He knew he always has this problem ever since he was a little kid. He cannot sit still in class, and interrupt the teacher without raising the hand to ask questions. He got himself into trouble by swearing at people without thinking. He is always on the go, and cannot hold down a job. He is too impatient to follow any instructions at work. He never finishes the work he was asked to do. He is having trouble in relationship because he constantly demands the love and attention and drove his partner up the wall. Yet he is highly creative and imaginative, but he doesn’t seem to put his thoughts down because he does not have the patience to sit down and put the creative ideas into practice. He is too forgetful. He is asking for help so he can put his life back together.
a. If you were a psychiatrist, based on the symptoms, what disorder is he likely to have? Please identify the characteristic symptoms that is unique to this disorder, such as behavioral characteristics, age of onset, etc.
b. What other disorders with similar symptoms do you need to exclude before you make the final diagnosis specific to this patient?
c. What screening tests would you use to find out if he has this disorder? Explain what these screening tests do.
d. What pharmacotherapy do you prescribe to this patient? Why do you think this drug treatment works according to the theory/model of this disorder?
e. What neurotransmitter do the above drugs act on? What are the side effects?
Explanation / Answer
a. According to all these symptoms, he is having Autistic Disorder which is called as Autism Spectrum Disorder (ASD). The main symptoms of autism include difficulty in attention, social interactions, and their bad communication behaviour. These symptoms generally appeared since childhood, and which becomes his significant impairement as an individual.
b. Other disorders such as some specific developmental disorders, which can be a language related disorders, may correlelate autism.
c. Screening tests can be useful to find out this disorder by using 1. Developmental Screening for testing developmental delays and disabilities like regular examination of his learning, speaking abilities and his behavior changes. 2. Comprehensive Screening for further evaluation through child neurologists and psychologists who can help in assess his mind and brain.
d. For this patient psychoactive or antianxiety drugs such as Benzodiazepines can be useful because these medications will slow down anxiety level and give relaxation.
e. These drugs act upon some receptors for neurotransmitters GABA (gamma-aminobutyric acid) present in the central nervous system and make them active, which further inhibits communication between nearby cells and in such manner helps in slow down brain activity by slowing functions of excitatory neurons.
Overdose and minimal toxicity of Benzodiazepines may cause side effects and produce symptoms including drowsiness, weakness, and breathing difficulties.
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