Written Assignment 3: Case Study Jessica
Please read the case below in which Jessica exhibits symptoms of a psychotic disorder, and then answer the questions regarding the case. Provide evidence from your text, relevant clinical guidelines, the DSM-5, and other relevant, credible sources.
Jessica, a 35-year-old female, presents to your outpatient behavioral health clinic for evaluation. She tells you that she has “an angel named Saint Rosa and a devil named Adam” who she sees and hears. Her father has similar symptoms but was never diagnosed with any psychiatric illness. She started having these hallucinations when she was a teenager. She reports she took olanzapine (Zyprexa) years ago, but she gained 35 pounds and stopped the medication. She has not tried any other antipsychotic medication. She says the voices are worse at times and better at times, and that now is a good time. She says Adam and Saint Rosa are mostly in the background at this time and are not causing distress. She is fearful that they will come back and cause distress, but she is also not sure if she wants them to go away because she wonders if God sent them to tell her something. She also says she talks out loud to herself, which eases her anxiety. It is bothersome to her husband and kids, though, and she wishes she did not have the urge to talk to herself. She asks you what her diagnosis is and if you think she needs medication. She wonders if her symptoms are her fault because she is not strong enough to overcome or interpret them.
Please answer the following questions regarding this case.
- What is Jessica’s probable diagnosis? Which DSM criteria for this diagnosis does she meet? What further information would you gather to better support your diagnosis?
- How would you explain her diagnosis to her? How would you answer her question as to whether or not it is her fault?
- Since she is not convinced she needs medication, how would you approach a conversation with her about a treatment plan?
- What medication would you recommend for Jessica? How would you explain to her the mechanism of action of these medications? What are the most likely and most worrisome possible side effects of this medication? Looking forward, what strategies could you use to address these potential side effects?
- Choose one abnormal involuntary movement that can be associated with the medication you chose. Describe the movement, how you would assess it, and how you would treat or manage it.
Your paper should be 600 to 750 words (2½ to 3 pages) with APA Style formatting. [MO 4.2, MO 4.3, MO 4.4].