Case_Study

Axis I 303.00 Alcohol Intoxication 292.89 Cannabis Intoxication Axis II None Axis III None Axis IV Axis V Axis I Bonita is an 18-year old college student who was brought to the emergency room because of a drug reaction. Bonita’s case raises two diagnostic questions that of a Cannabis Intoxication and that of a Alcohol Intoxication disorder. First, she found it difficult to breathe her lungs seemed to hurt. She began to feel tightness in her head. She is experience impaired motor coordination; she was unable to move her legs. However, the criteria for a Cannabis Intoxication stipulate that there be maladaptive behavioral or psychosocial changes (e.g., impaired motor coordination, euphoria, anxiety, sensation of slowed time, impaired judgment, social withdrawal that develop during, or shortly after, cannabis use” (American Psychiatric Association, Diagnostic and statistical m annual of mental disorder, 4th edition, text revision, 2000, p. 237). In this case she exhibit symptoms shortly after her cannabis use. Second, Bonita had consumed some beer. Shortly after she develops some symptoms and an hour later, she began to panic. She also acknowledges that she had consumed some bear a few days ago but did not develop any symptoms. She was in some distress and and experience a panic attack hour after, she felt as if she would die or go mad. DSM-IV-TR delineates that Alcohol Intoxication “is the presence of clinically significant maladaptive behavioral or psychological changes associated with intoxication” American Psychiatric Association, Diagnostic and statistical m annual of mental disorder, 4th edition, text revision, 2000, p. 237). She recently used alcohol and shortly after the alcohol ingestion developed symptoms. Differential Diagnosis Bonita’s differential diagnose of Substance Intoxication may be made if the “symptoms are not due to a general medical condition and not better accounted for by another mental disorder “(American Psychiatric Association, Diagnostic and statistical m annual of mental disorder, 4th edition, text revision, 2000, p. 1999). Another deciding factor that points to a diagnosis of substance intoxication is that the diagnosis of a substance related disorder requires the identification of the abused substance(s) and the description of its current pattern of use. “The cage and audit are effective questionnaire for screening those who are suspected of having a substance related disorder” (Maxmen & Ward, p.248). In her case, hospital staff did not screen her for any substances. Therefore, the diagnosis of a substance intoxication is most likely diagnosis based on Bonita’s symptoms despite the absence of an identified substance in the emergency room. Axis II Bonita did not display any of the requirements for a personality disorder or mental retardation. Axis III There are no general medical conditions Axis IV Axis V Optimal Treatment In cases such as this, the treatment of alcohol dependence is abstinence and Alcoholics Anonymous (or an equivalent recovery program). Why did I choose this Treatment' Because, the disease of substance abuse is complex in nature and abstinence is the best treatment. It affects every organ; it causes anemia, muscle weakness, gastritis, diarrhea, ulcers, pancreatitis, fetal alcohol syndrome, and other birth defects” (Maxmen & Ward, p.281). If the disorder is not promptly treated, she is at risk for a degenerative medical condition. Three or four beers a day over 15 years results in cirrhosis in 18% of people. One principle of addiction treatment is that “the recovering addict must change people, places, and things that were associated with his or her addictive addiction” ( Maxmen & Ward, p.281). Effective addiction treatment curbs the nature of addiction Prognosis Prognosis is long term with proper treatment to avoid relapse. In less severe cases, complete recovery may occur slowly over a period of months. Justification of the Prognosis Because “spontaneous improvement is more common than generally realized, if people with alcoholism can keep functioning when they reach midlife, their long term prognosis improves considerably” (Maxmen & Ward, p.257).