Question

Case D: A 43 year old African American Male S.O, is a father of two. He came to the clinic with depression. He had stopped going to work stating “my boss hates me and he always like to get me in trouble.” Patient came in with wife who is very supportive. History shows patient had being treated for psychosis schizophrenia, has had two inpatient and many outpatient hospitalization. Two months ago, patient mildly agitated. Wife reported that he was pulling furniture behind the doors of the living room saying “they are trying to break into ou5r house.” Patient has become isolative, eating less and often don’t want to go out of the house. Stopped taking medication 2-4 weeks ago, stating it is a poison.

Clinical Impressions: (Rationale for diagnosis and recommendations for services)

DSM-5 Diagnosis with list of diagnostic creterials:                                   

Recommendations:

Labs:

Psychiatric Medications:                                                                                                                                                                                          

Drug:                                            Dose/Schedule:                            Number/Refill:                                           Fact Sheet Given     Other

Rationale for each recommendation

Teaching

What would you include in a biopsychosocial treatment plan for the patient in addition to pharmacotherapy?

Answer 1

Some of the recommendation for these types of patients are

• Early intervention for depression prevents further complications
• Treating and referring people
• Support carers because they may sometimes be exhausted by taking care of ill patients
• Treating physical health problems and continuing care
• Long term care has to be planned.

In biopsychosocial treatment the following can be included

• Diversional therapy
• Meditation,Yoga
• Psychotherapy
• Holistic approach
• Relaxation therapy
• Assessment of health and overall treatment
• Interacting with the society
• Health education on activities of daily living

Pharmacotherapy usually includes antipsychotic drugs.