IMC sciences psychiques 1.

.1 Mike His mother taught the man has a problem although he doesnt think he has any issue so was hospitalized as a fear that he might hurt his mother. Doesnt remember much why he was hospitalized? Multiple hospitalization Had to take medications they make him tired but forced to take the medications (in the hospital). After his leave from his hospital, he might stops taking them. Lives with his mother desire to move out one day, and get a job (he worked once at a restaurant cleaning table). I dunno his characteristic statement. Feels people might hurt him such as his mother Auditory hallucination (negative statement dont like his mother the voice) Doesnt think hes depressed at the moment or never before. Never attempted suicide Took illicit drugs in the past (years ago - apparently doesnt do it anymore) Occasional drinker. Actually never did in the past according to him He apparently doesnt remember much but it seems rather he is hiding info. Not a memory issue (cuz he remembers things from episodic memory) but rather an attentional deficit cuz hell often ask the therapist to repeat the Q and take the same sentence to build answer the Q. They can often be mistaken for memory deficit. Magical thinking: hell find a job and move out expect everything will resolve overnight. He seems rather passive. Lacks insight about the medical condition such as cessation of medication and also in regards to his auditory hallucination. Affect plat no fear about his auditory hallucination, no emotions towards his mother Delirious disorganized/paranoid some people out there to get him not sure whom. Impaired functionality ALWAYS eliminate all organic causes (medical condition: hyperthyroid) and substance abuse then eliminate all affective diseases (cuz more readily treatable eg. Depression, suicidal, bipolar) which allows to move to psychotic diseases dx. Personality disorders = long term and not acute cuz becomes a definition of ones identity; hence, try to keep as a last recourse. DX: Schizophrenia (delirium, hallucination, discourse disorganized, catatonic comportement) Sx ve: perd motivation, isolation retire quelque chose present au comportement. Sx +ve: ajout de sx avant absent comme hallucination. 1.2 Joan Constant worry (eg. Job performance, her teenagers being abducted) Almost all her life

Aware people doesnt like to be around her in her worry stade Came to seek therapist help in the past and today voluntarily Has taken medication eg. Valium Never hospitalized afore Can somewhat make her depressed (the sx). Her worry may cause her some difficulty to fall asleep but once asleep it doesnt impact her sleep pattern. Never thought about hurting herself in past. VERY hard to make decision mind can become blank No member of her family has psychiatric issue Not comfortable talking to therapist find comfort at home but no issue in leaving home. Doesnt need to avoid crowd Fatigue and tired most of time Never took drug beforehand Not an easy person to get along Her worry interferes with her work trouble staying at work and completing it. Worry in a generalized manner many spheres of her life (work, kids, chicken, work performance). Very alert of her issue and its interference in her life (insight present). Her anxious nature interfere her life, work, etc. Affect: trouble sleeping, fatigue, irritable. (but no sx agoraphobia) Suffering from her condition and can verbalized her pain Chronic (months, years) kinda like her normal mode of functionality. DX: trouble anxiety generalized (soucis excessive for at least 6 mths, tension musculaire, changement de sommeil, always moving cant stop, dont feel comfortable). Not always related to substance abuse or medical condition. NOTE: depression 1) sadness on continuous basis almost everyday or 2) lack of interest in activity but here she has general sx of depression yet capable to go to work and doesnt seem sadden.

1.3 Mel Things fine at work: promotion Feels great. Play golf. Has down period will sleep more and may have hard time getting out of bed. Getting 4 hours of period currently and feel great. Contrasts btw up and down period. Work long hours and may skip meal to get work done but very passionate of his work in his up period. Never lose touch with reality. Doesnt result in conflict with other but on the contrary very productive. Down period: difficult, low energy, some suicidal thoughts work doesnt seem to be worth going to- but never attempted it, last 2-4 days, food not the same lack of appetite, weight loss, never hospitalized. Seek tx for these periods psychotherapy but wasnt helpful so then was given ATB.

Family history requiring hospitalization for depression. No medical program. Occasional drinker Not a drug user except coffee - couple cups at morning Duality of two periods: depressive vs euphoric good period. ATCD medical psychiatrique. His mothers disease is worse requiring hospitalization. When depressed typical classical portrait In his episode = hypomaniac cuz it doesnt interfere with his functionality (vs maniac where you have interference). DX: Bipolar disorder type 2 The moment you have a maniac episode either immediate or in the past = BP type 1. Irritable in manic or hypomanic episode cuz preventing them from doing their activity. Some people are very functional in mode of hyperactivity (here important to note the change in his workability or his baseline functionality). If at the basis, a person is very hyperactive, requires little sleep, dedicated, etc. not hypomanic.

1.4 Marcella Horrible attack: heart pounding, cant breathe, gets shaky, losing control, feeling that could die which worsen her fear further of death. 3X/ yrs no problem except during the episode episode for her seems like hours but in fact a few minute unexpected onset worry her cuz doesnt know when the next attack will come Constant eye movement DX: panic disorder 1.6 Eddie He doesnt remember much his friends took to his hospital, god sedative injection and remained there for a couple of days. His friends took him to the hospital that he might hurt himself or someone else. Couple of strangers whispering about getting Eddie kidnapped and take him to new Orleans He gets vibe of people Never been to hospital or psychiatric ward (up till now all sx points toward psychotic portrait) Doing meth at the time of episode (ALWAYS remove organic cause cuz the drug plays an important role in contributing to sx. Gives very similar portrait of psychotic. Hard to distinguish hence why always seek the information)

Urinary test only confirm or infirm the dx we pose based on SX. Furthermore, test not entirely reliable cuz some drugs are eliminated very rapidly (eg. Cocaine)

1.8 Jane Problem several onset fainting + dizziness interference with work and her life Numerous tests done plus seen several consultants Been in hospital for 5 days now was about to be discharged but then fainted again. Afraid to drive but havent miss her work and so far can keep up with it No medication or prescription Medication found in her room she says not her medication despite doctor believing otherwise No psychiatric problem beforehand she is NOT mental No family history of psychiatric problem Her hospital record shows that she has been hospitalized beforehand cuz she is sick! She is going complaint to about everyone in all the boards possible. Changement of attitude when confronting. From being open to closing up and becoming irritable. Aware of a problem but belief not of psychiatric disorder. Sx may be linked to the medication and she is probably aware that they are her own. Seeking attention of her doctor as role of patient. She is SICK but not MENTAL. Goes to work, not looking for financial compensation. DX: trouble factitious (provoque sx dans le but detre malade)