Chief Compliant anxious and worried. HPI: This is a 7-year-old male, brought in by mother with concerns of being anxious and worried. The pt. reports that he worries about everything. Reports having dreams every night about losing mom or little brother and cant find them. The pt. has never been lost before, and reports that he doesnt like the dark and sleeps with a night light. When at school he worries about mom and brother and states nobody likes me at school they call me Mr. Smelly. The pt. reports that he has night accidents, and he doesnt take baths like his mom tell him too. The night accidents make him feel sad and really bad, he reports that his classmates dont know how it feels for dad to never come home and it worries him that his mom may not come home too. He reports that his teacher tells him to sit down and focus a lot. He states that he gets in trouble with his teacher for looking out the window, and she moved him to sit next to her desk. Reports no harm to self but states he threw a book at classmate. Per mom, the pt. worries that she is going to die and that she wants to pick him up from school and he feels that she loves his little brother more than him. She also reports that the pt. sometimes throws things around the house, and he gets in trouble for throwing things at school. She states that the pt. has a difficult time going to sleep, he gets up often, wants his lights on and the door open, hes always wanting to come home from school c/o a stomachache and his appetite has decrease resulting in a 3 lbs. weight loss in 3 weeks. Mom states that the pt. father was deployed with the military and was killed during the deployment and the pt. doesnt understand that his father just didnt leave him intentionally. What were your differential diagnoses? (This has been provided for you) 1. Separation Anxiety disorder, 2. PTSD, and 3. Generalized anxiety disorder. Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case. What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy. What would you do differently with this patient if you could conduct the session again? Discuss what your next intervention would be if you could follow up with this patient.?Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion, and disease prevention, taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (., socioeconomic, cultural background, etc.). Provide at least Three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).Show more
