Sign Up Now
Get instant access to over 1 million+ study documents
OR
Already registered? click here to login
By creating your account, you agree to our terms of service, privacy policy and student honor code.
¶ … patient C.W.:
Discuss the differential diagnoses and rationale for choosing the primary diagnoses
"There has been little systematic study of personality disorders in older people (65 years of age and above). However, with an ageing population worldwide we should expect to find increased numbers of people with Axis II disorders surviving into old age" (Mordekar & Spence 2007 ). Based upon the patient C.W.'s previous psychiatric history, his likely primary diagnosis would be that of a paranoid personality disorder. According to the definition provided by the ICD9 301 codes for this condition, paranoid personality disorder is distinct from full-blown schizophrenia. Unlike schizophrenics, the patient does not exhibit the hallucinations and delusions characteristic of individuals suffering this condition.
However, the patient does show a persistent pattern of mistrust that is damaging for his health. He has refused any type of medical intervention, including vaccinations as well as medications and therapy. He repeatedly denies the presence of even obvious injuries to medical practitioners because of his mistrust of others. He similarly refuses treatment, stating that drugs are money-making schemes and not designed to help him. "Individuals with Paranoid Personality Disorder falsely believe that they are being victimized...
... Minor slights arouse major hostility, and the hostile feelings persist for a long time. Their combative and suspicious nature may elicit a hostile response in others, which then serves to confirm their original expectations" (Long 2015). The patient shows marked hostility to all members of the medical profession and even his close family members have had difficulties in ensuring that he undertake positive and proactive measures to engage in self-care in the face of the inevitable symptoms of aging.
Although some older individuals experience paranoia as a consequence of dementia, based on the patient's medical history this appears to be a long-standing personality problem. "The effectiveness of treatment for Paranoid Personality Disorder is unknown because there are no randomized controlled trials. Individuals with this disorder seldom voluntarily present for treatment" (Long 2015). A full evaluation by a psychiatrist would be needed to see if any antipsychotics might be helpful but in general personality disorders do not respond well to psychopharmacology, in contrast to schizophrenia. The patient has admitted to heavy drinking and some of his symptoms may be the result of substance abuse. This should also be evaluated by the psychiatrist when prescribing a course of treatment. When diagnosing a personality disorder, it is…
Reference
ICD-9 Code Lookup. (2015). Retrieved from:
https://www.cms.gov/medicare-coverage-database/staticpages/icd-9-code-lookup.aspx
Long, P. (2015). Paranoid personality disorder. Internet Mental Health. Retrieved from:
http://www.mentalhealth.com/home/dx/paranoidpersonality.html
http://apt.rcpsych.org/content/14/1/71
Diagnosis and Treatment Axis II of the DSM covers personality disorders extensively, illuminating the criteria by which personality disorders can be diagnosed, and allowing clinicians to effectively distinguish between them in order to provide the most accurate diagnosis and treatment plan for the client. As a multi-model model, the DSM also allows clients like Mary to be treated for additional clinical conditions and accounts for comorbidity. Alternative models of personality disorder
These people have been seen to have rigidity towards people who are struggling in life and are going through a tougher time or with people who are already emotionally weak or vulnerable in case where they might be going through a tough relationship. It has been reported that if these people are asked for advice for better parenting with a troubled teen, the advice from an overtly controlling person
Therefore, it is likely that "men who are highly comorbid for antisocial PD and alcohol and drug use disorders are more likely to die young or be incarcerated than women and thus less likely to be represented in general population surveys." (Grant et al., 2006, p. 128). However, because incarcerated or dead men do not present for treatment, these findings are still of use to the practitioner. Conclusion Both articles do
PERSONALITY DISORDERS CONTROVERSYControversies Associated with Personality DisorderFrom the onset, it would be prudent to note that as per the Diagnostic and Statistical Manual on Mental Disorders, Fifth Edition (DSM-5), personality disorders could be defined as �an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual�s culture� (National Institute of Mental Health � NIMH, 2017). There are various personality disorders recognized under the DSM-5
personality" and personalities. Everyone has a personality, their own unique collection of traits and characteristics. The facets of a person's personality may be partly inherited and partly the result of the person's life experiences. In the personality disorder, the person has inflexible traits and patterns of behavior not typical of most people and that cause the person to function poorly in life. Up to 13% of people may have
32) The overall diagnostic and symptomatic patterns described by these points indicate that BPD is a serious disorder and is "...classified as a major personality disorder involving dramatic, emotional, or erratic behavior; intense, unstable moods and relationships; chronic anger; and substance abuse." (Boucher, 1999, p. 33) There are a number of criteria which, in line with DSM-IV, are used to identify and characterize this disorder. The first of these criteria refers