Reference no: EM133917516
Question
The patient is a 19-year-old female who presents with the following symptoms which have been present for "years." She was raised by her mother who was neglectful, physically, and verbally abusive. The patient's mother would disappear for days leaving the patient to care for her younger sister. The patient's mother used alcohol and had numerous boyfriends, many of whom were abusive. The patient and her sister were molested by several of the boyfriends. The patient generally avoids talking about her childhood abuse but has reported previous incidents of molestation and abuse during which she feared that she and her sister were going to be killed. She finds it difficult to remember but when she does recall events, she becomes distressed and angry. She has nightmares about her childhood abuse. She thinks she is a bad person and feels guilty because she did not protect her sister. She sometimes thinks that it would be better if she were dead but denies a suicidal plan or an intention of suicide. She feels on "high alert". She would like to be able to sleep through the night but awakens frequently. She gets frustrated easily and directs her frustration and anger toward her co-workers. She is currently on probation at work related to her angry outbursts. She denies substance use. She has no previous hospitalizations or psychiatric treatment.
The patient has a history of gastroesophageal reflux disease.
1. What are the differential diagnoses? Rationales.
2. What are the patient's diagnoses? List DSM-5 diagnostic criteria and the patient's symptoms that reflect the diagnostic criteria to support the diagnosis(es).
3. What level of care is appropriate for the patient? Provide rationale.
4. What screening tools are appropriate to use to assist with diagnosis?
5. What diagnostic labs would you order? Provide rationales.
6. What are the red flags in this patient's presentation?
7. What treatments would be appropriate to include psychopharmacology and psychotherapy for the patient? Provide rationales.