Diagnostic and Statistical Manual of Mental Disorders Assignment

Diagnostic and Statistical Manual of Mental Disorders Assignment

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Week 4: Anxiety Disorders, PTSD, and OCD
Your own experiences might tell you that expectations from family, friends, and work—as well as your own expectations regarding achievement, success, and happiness—can create stress. Stressors are a normal part of life, and stress traditionally has been viewed as an adaptive function with a set of physiological responses to a stressor. In a situation where stress is perceived, the organism is physiologically prepared to attack or flee from the threat. Those with effective fight or flight responses tended to survive long enough to reproduce, so we are descended from those who are genetically hardwired for self-protection. When you experience stress, your biology, emotions, social support, motivation, environment, attitude, immune function, and wellness all feel the ripple effect. Diagnostic and Statistical Manual of Mental Disorders Assignment

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This stress response is an adaptive response the human body has to threats; however, stress can also be difficult to handle and—depending upon the nature and intensity of the stress—can result in anxiety disorders, obsessive-compulsive disorders, or trauma- and stressor-related disorders. This week, you will focus on these disorders and explore strategies to accurately assess and diagnose them.
Learning Objectives Diagnostic and Statistical Manual of Mental Disorders Assignment
Students will:
• Apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information
• Formulate differential diagnoses using DSM-5 criteria for patients with anxiety disorders, PTSD, and OCD across the lifespan

Learning Resources

Required Readings Diagnostic and Statistical Manual of Mental Disorders Assignment

American Psychiatric Association. (2013). Anxiety disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm05

American Psychiatric Association. (2013). Obsessive compulsive and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm06 Diagnostic and Statistical Manual of Mental Disorders Assignment

American Psychiatric Association. (2013). Trauma- and stressor-related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm07

Sadock, B. J., Sadock, V. A., and Ruiz, P. (2015). Kaplan & Sadockâ€s synopsis of psychiatry (11th ed.). Wolters Kluwer.
• Chapter 9, Anxiety Disorders
• Chapter 10, Obsessive-Compulsive and Related Disorders
• Chapter 11, Trauma- and Stressor-Related Disorders
• Chapter 31.11 Trauma-Stressor Related Disorders in Children
• Chapter 31.13 Anxiety Disorders in Infancy, Childhood, and Adolescence Diagnostic and Statistical Manual of Mental Disorders Assignment
• Chapter 31.14 Obsessive-Compulsive Disorder in Childhood and Adolescence

Document: Comprehensive Psychiatric Evaluation Template

Week (enter week #): (Enter assignment title) Diagnostic and Statistical Manual of Mental Disorders Assignment

Student Name
College of Nursing-PMHNP, Walden University
NRNP 6635: Psychopathology and Diagnostic Reasoning
Faculty Name
Assignment Due Date

Subjective:
CC (chief complaint):
HPI:
Past Psychiatric History:
• General Statement:
• Caregivers (if applicable):
• Hospitalizations:
• Medication trials:
• Psychotherapy or Previous Psychiatric Diagnosis:
Substance Current Use and History:
Family Psychiatric/Substance Use History:
Psychosocial History: Diagnostic and Statistical Manual of Mental Disorders Assignment
Medical History:

• Current Medications:
• Allergies:
• Reproductive Hx:
ROS:
• GENERAL:
• HEENT:
• SKIN:
• CARDIOVASCULAR:
• RESPIRATORY:
• GASTROINTESTINAL:
• GENITOURINARY:
• NEUROLOGICAL: Diagnostic and Statistical Manual of Mental Disorders Assignment
• MUSCULOSKELETAL:
• HEMATOLOGIC:
• LYMPHATICS:
• ENDOCRINOLOGIC:
Objective:
Physical exam: if applicable
Diagnostic results:
Assessment:
Mental Status Examination:
Differential Diagnoses:
Reflections:
References

INSTRUCTIONS ON HOW TO USE EXEMPLAR AND TEMPLATE—READ CAREFULLY Diagnostic and Statistical Manual of Mental Disorders Assignment
If you are struggling with the format or remembering what to include, follow the Comprehensive Psychiatric Evaluation Template AND the Rubric as your guide. It is also helpful to review the rubric in detail in order not to lose points unnecessarily because you missed something required. Below highlights by category are taken directly from the grading rubric for the assignment in Weeks 4–10. After reviewing the full details of the rubric, you can use it as a guide.
In the Subjective section, provide: Diagnostic and Statistical Manual of Mental Disorders Assignment
• Chief complaint
• History of present illness (HPI)
• Past psychiatric history
• Medication trials and current medications
• Psychotherapy or previous psychiatric diagnosis
• Pertinent substance use, family psychiatric/substance use, social, and medical history
• Allergies
• ROS
• Read rating descriptions to see the grading standards!

In the Objective section, provide:
• Physical exam documentation of systems pertinent to the chief complaint, HPI, and history
• Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses.
• Read rating descriptions to see the grading standards! Diagnostic and Statistical Manual of Mental Disorders Assignment

In the Assessment section, provide:
• Results of the mental status examination, presented in paragraph form.
• At least three differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case. Diagnostic and Statistical Manual of Mental Disorders Assignment
• Read rating descriptions to see the grading standards!
Reflect on this case. Include: Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
(The comprehensive evaluation is typically the initial new patient evaluation. You will practice writing this type of note in this course. You will be ruling out other mental illnesses so often you will write up what symptoms are present and what symptoms are not present from illnesses to demonstrate you have indeed assessed for all illnesses which could be impacting your patient. For example, anxiety symptoms, depressive symptoms, bipolar symptoms, psychosis symptoms, substance use, etc.) Diagnostic and Statistical Manual of Mental Disorders Assignment

EXEMPLAR BEGINS HERE
CC (chief complaint): A brief statement identifying why the patient is here. This statement is verbatim of the patientâ€s own words about why presenting for assessment. For a patient with dementia or other cognitive deficits, this statement can be obtained from a family member.
HPI: Begin this section with patientâ€s initials, age, race, gender, purpose of evaluation, current medication and referral reason. For example:
N.M. is a 34-year-old Asian male presents for psychiatric evaluation for anxiety. He is currently prescribed sertraline which he finds ineffective. His PCP referred him for evaluation and treatment. Diagnostic and Statistical Manual of Mental Disorders Assignment
Or
P.H., a 16-year-old Hispanic female, presents for psychiatric evaluation for concentration difficulty. She is not currently prescribed psychotropic medications. She is referred by her therapist for medication evaluation and treatment.
Then, this section continues with the symptom analysis for your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis.
Paint a picture of what is wrong with the patient. First what is bringing the patient to your evaluation. Then, include a PSYCHIATRIC REVIEW OF SYMPTOMS. The symptoms onset, duration, frequency, severity, and impact. Your description here will guide your differential diagnoses. You are seeking symptoms that may align with many DSM-5 diagnoses, narrowing to what aligns with diagnostic criteria for mental health and substance use disorders. Diagnostic and Statistical Manual of Mental Disorders Assignment
Past Psychiatric History: This section documents the patientâ€s past treatments. Use the mnemonic Go Cha MP.
General Statement: Typically, this is a statement of the patients first treatment experience. For example: The patient entered treatment at the age of 10 with counseling for depression during her parents†divorce. OR The patient entered treatment for detox at age 26 after abusing alcohol since age 13.
Caregivers are listed if applicable.
Hospitalizations: How many hospitalizations? When and where was last hospitalization? How many detox? How many residential treatments? When and where was last detox/residential treatment? Any history of suicidal or homicidal behaviors? Any history of self-harm behaviors? Diagnostic and Statistical Manual of Mental Disorders Assignment
Medication trials: What are the previous psychotropic medications the patient has tried and what was their reaction? Effective, Not Effective, Adverse Reaction? Some examples: Haloperidol (dystonic reaction), risperidone (hyperprolactinemia), olanzapine (effective, insurance wouldnâ€t pay for it)
Psychotherapy or Previous Psychiatric Diagnosis: This section can be completed one of two ways depending on what you want to capture to support the evaluation. First, does the patient know what type? Did they find psychotherapy helpful or not? Why? Second, what are the previous diagnosis for the client noted from previous treatments and other providers. Thirdly, you could document both. Diagnostic and Statistical Manual of Mental Disorders Assignment
Substance Use History: This section contains any history or current use of caffeine, nicotine, illicit substance (including marijuana), and alcohol. Include the daily amount of use and last known use. Include type of use such as inhales, snorts, IV, etc. Include any histories of withdrawal complications from tremors, Delirium Tremens, or seizures.

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Family Psychiatric/Substance Use History: This section contains any family history of psychiatric illness, substance use illnesses, and family suicides. You may choose to use a genogram to depict this information. Be sure to include a readerâ€s key to your genogram or write up in narrative form.
Social History: This section may be lengthy if completing an evaluation for psychotherapy or shorter if completing an evaluation for psychopharmacology. However, at a minimum, please include:
Where patient was born, who raised the patient Diagnostic and Statistical Manual of Mental Disorders Assignment
Number of brothers/sisters (what order is the patient within siblings)
Who the patient currently lives with in a home? Are they single, married, divorced, widowed? How many children?
Educational Level
Hobbies:
Work History: currently working/profession, disabled, unemployed, retired?
Legal history: past hx, any current issues?
Trauma history: Any childhood or adult history of trauma?
Violence Hx: Concern or issues about safety (personal, home, community, sexual (current & historical)

Medical History: This section contains any illnesses, surgeries, include any hx of seizures, head injuries. Diagnostic and Statistical Manual of Mental Disorders Assignment

Current Medications: Include dosage, frequency, length of time used, and reason for use. Also include OTC or homeopathic products.
Allergies: Include medication, food, and environmental allergies separately. Provide a description of what the allergy is (e.g., angioedema, anaphylaxis). This will help determine a true reaction vs. intolerance. Diagnostic and Statistical Manual of Mental Disorders Assignment
Reproductive Hx: Menstrual history (date of LMP), Pregnant (yes or no), Nursing/lactating (yes or no), contraceptive use (method used), types of intercourse: oral, anal, vaginal, other, any sexual concerns
ROS: Cover all body systems that may help you include or rule out a differential diagnosis. Please note: THIS IS DIFFERENT from a physical examination!
You should list each system as follows: General: Head: EENT: etc. You should list these in bullet format and document the systems in order from head to toe. Diagnostic and Statistical Manual of Mental Disorders Assignment
Example of Complete ROS:
GENERAL: No weight loss, fever, chills, weakness, or fatigue.
HEENT: Eyes: No visual loss, blurred vision, double vision, or yellow sclerae. Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose, or sore throat.
SKIN: No rash or itching.
CARDIOVASCULAR: No chest pain, chest pressure, or chest discomfort. No palpitations or edema.
RESPIRATORY: No shortness of breath, cough, or sputum.
GASTROINTESTINAL: No anorexia, nausea, vomiting, or diarrhea. No abdominal pain or blood.
GENITOURINARY: Burning on urination, urgency, hesitancy, odor, odd color
NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness, or tingling in the extremities. No change in bowel or bladder control. Diagnostic and Statistical Manual of Mental Disorders Assignment
MUSCULOSKELETAL: No muscle, back pain, joint pain, or stiffness.
HEMATOLOGIC: No anemia, bleeding, or bruising.
LYMPHATICS: No enlarged nodes. No history of splenectomy.
ENDOCRINOLOGIC: No reports of sweating, cold, or heat intolerance. No polyuria or polydipsia.
Physical exam (If applicable and if you have opportunity to perform—document if exam is completed by PCP): From head to toe, include what you see, hear, and feel when doing your physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and History. Do not use “WNL” or “normal.” You must describe what you see. Always document in head-to-toe format i.e., General: Head: EENT: etc. Diagnostic and Statistical Manual of Mental Disorders Assignment
Diagnostic results: Include any labs, X-rays, or other diagnostics that are needed to develop the differential diagnoses (support with evidenced and guidelines).
Assessment
Mental Status Examination: For the purposes of your courses, this section must be presented in paragraph form and not use of a checklist! This section you will describe the patientâ€s appearance, attitude, behavior, mood and affect, speech, thought processes, thought content, perceptions (hallucinations, pseudohallucinations, illusions, etc.)., cognition, insight, judgment, and SI/HI. See an example below. You will modify to include the specifics for your patient on the above elements—DO NOT just copy the example. You may use a preceptorâ€s way of organizing the information if the MSE is in paragraph form. Diagnostic and Statistical Manual of Mental Disorders Assignment
He is an 8-year-old African American male who looks his stated age. He is cooperative with examiner. He is neatly groomed and clean, dressed appropriately. There is no evidence of any abnormal motor activity. His speech is clear, coherent, normal in volume and tone. His thought process is goal directed and logical. There is no evidence of looseness of association or flight of ideas. His mood is euthymic, and his affect appropriate to his mood. He was smiling at times in an appropriate manner. He denies any auditory or visual hallucinations. There is no evidence of any delusional thinking. He denies any current suicidal or homicidal ideation. Cognitively, he is alert and oriented. His recent and remote memory is intact. His concentration is good. His insight is good.
Differential Diagnoses: You must have at least three differentials with supporting evidence. Explain what rules each differential in or out and justify your primary diagnosis selection. You will use supporting evidence from the literature to support your rationale. Include pertinent positives and pertinent negatives for the specific patient case. Diagnostic and Statistical Manual of Mental Disorders Assignment

Also included in this section is the reflection. Reflect on this case and discuss whether or not you agree with your preceptorâ€s assessment and diagnostic impression of the patient and why or why not. What did you learn from this case? What would you do differently?
Also include in your reflection a discussion related to legal/ethical considerations (demonstrating critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.). Diagnostic and Statistical Manual of Mental Disorders Assignment
References (move to begin on next page)
You are required to include at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines which relate to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 7th edition formatting.

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Required Media (click to expand/reduce)

Classroom Productions. (Producer). (2015). Anxiety disorders [Video]. Walden University. Diagnostic and Statistical Manual of Mental Disorders Assignment

Classroom Productions. (Producer). (2012). The neurobiology of anxiety [Video]. Walden University.

Classroom Productions. (Producer). (2015). Obsessive-compulsive disorders [Video]. Walden University.

Classroom Productions. (Producer). (2015). Trauma, PTSD, and Trauma-Informed Care [Video]. Walden University.

MedEasy. (2017). Anxiety, OCD, PTSD and related psychiatric disorders | USMLE & COMLEX [Video]. YouTube. https://www.youtube.com/watch?v=-BwzQF9DTlY Diagnostic and Statistical Manual of Mental Disorders Assignment

TRANSCRIPT OF VIDEO FILE: Do Complete Psychiatric Evaluation on the following transcript
00:00:00______________________________________________________________________________
00:00:00BEGIN TRANSCRIPT:
00:00:00[sil.]
00:00:15[She nervously plays with her scarf as she breathes anxiously]
00:00:25OFF CAMERA Hello Mrs. Weidre. Are you ok? Do you want some water or something? Diagnostic and Statistical Manual of Mental Disorders Assignment
00:00:30MRS. WEIDRE I’m ok. I’m fine.
00:00:35OFF CAMERA I understand you wanted to see me today.
00:00:40[She breathes anxiously]
00:00:40MRS. WEIDRE I just really needed to sit and talk.
00:00:40OFF CAMERA Well, tell me what’s wrong, what are you feeling?
00:00:50MRS. WEIDRE I’m just so… so unsure. I’m tired of being stuck in my house. I don’t like it.
00:01:00OFF CAMERA Stuck in your house? Do you have difficultly leaving your house?
00:01:05MRS. WEIDRE Yes. All the time. Diagnostic and Statistical Manual of Mental Disorders Assignment
00:01:05OFF CAMERA When do you go out?
00:01:10MRS. WEIDRE …maybe, once or twice.
00:01:15OFF CAMERA A day?
00:01:15[She clutches her hands to her chest]
00:01:15MRS. WEIDRE A week. Tuesdays and Saturdays.
00:01:20OFF CAMERA Why Tuesday and Saturday?
00:01:30MRS. WEIDRE Because when my husband gets home, he can go with me.
00:01:35OFF CAMERA What do you do when you go out?
00:01:40MRS. WEIDRE I take walks.
00:01:40OFF CAMERA Where do you walk?
00:01:40MRS. WEIDRE I only go to the end of the block, and then I cross the street, and turn around, and I go back around the cul-de-sac. I’ll do that three times. [Losing breathe] No more, then I have to go back inside… I also go in my backyard. That’s usually okay. Diagnostic and Statistical Manual of Mental Disorders Assignment
00:02:15OFF CAMERA On the walks, why do you have to go back after three times? What happens?
00:02:20MRS. WEIDRE [She nervously looks around] I just can’t go any further.
00:02:25OFF CAMERA Is this a physical problem, knees or something?
00:02:30[She plays with her scarf]
00:02:30MRS. WEIDRE No. No. Well… maybe. I just can’t breathe if I’m out any longer.
00:02:40OFF CAMERA Oh, breathing? Diagnostic and Statistical Manual of Mental Disorders Assignment
00:02:40MRS. WEIDRE Yeah.
00:02:40OFF CAMERA What do you feel?
00:02:45MRS. WEIDRE [Her voice quivering] I’m just so frightened. Really, really scared. You don’t realize what it took for me to get here today. I really had to. I willed it. I closed my eyes and my husband turned the radio up all the way as he drove. And then he lead me into the building.
00:03:20OFF CAMERA Is there something that triggers this, anything in particular?
00:03:30MRS. WEIDRE I don’t like people. Maybe that’s it. I mean I can tolerate them. Ethan, the little boy next door, I’ll bake things for him and say hello. Sometimes, sometimes I watch him when his parents are gone. I mean I can be around people. Maybe that’s not that’s not what I meant. Diagnostic and Statistical Manual of Mental Disorders Assignment
00:04:00OFF CAMERA Ok, can you walk me through what happens when you do leave the house?
00:04:05MRS. WEIDRE I get shortness of breathe, everything, the world just seems to close in on me, and everything gets feels really tight, the air in my body, my chest. I get dizzy. I don’t know what’s wrong… I could be sick. What is this?
00:04:30OFF CAMERA There can be many different causes for this. What is it that frightens you?
00:04:40MRS. WEIDRE [She’s short of breathe] Death. I’m afraid to die. Diagnostic and Statistical Manual of Mental Disorders Assignment
00:04:45OFF CAMERA You’re afraid you might die?
00:04:50MRS. WEIDRE Yes. Among other things but that’s what pops into my head.
00:04:55OFF CAMERA Is there other stuff?
00:05:00[sil.]
00:05:05MRS. WEIDRE Cars go to fast. And there’s murders and rapes that I see on the news. And flashfloods. I just think its close, its safer to stay close to home. Diagnostic and Statistical Manual of Mental Disorders Assignment
00:05:15OFF CAMERA How long have you had this fear?
00:05:20MRS. WEIDRE I don’t really know.
00:05:20OFF CAMERA Do you know when it all started?
00:05:25MRS. WEIDRE I’m not sure.
00:05:30OFF CAMERA Do you know what started it?
00:05:30MRS. WEIDRE No.
00:05:35OFF CAMERA When was the last time you really ventured out for any length of time? Diagnostic and Statistical Manual of Mental Disorders Assignment
00:05:40MRS. WEIDRE Fifteen years.
00:05:45[She nervously shifts in her chair]
00:05:45OFF CAMERA That long. Is this the farthest you’ve been in fifteen years? What happened fifteen years ago?
00:06:00MRS. WEIDRE I don’t really know.
00:06:05OFF CAMERA There is nothing that happened to you personally that could have made you afraid of dying?
00:06:10MRS. WEIDRE I always was. My mother died the year before that. But it happened little by little. First it was planes. And then I couldn’t drive on the freeway, then I couldn’t drive at all, then errands, then it was going out… and soon… here I am. Diagnostic and Statistical Manual of Mental Disorders Assignment
00:06:40OFF CAMERA It must have taken you extraordinary courage to come here today. What finally brought you to see me?
00:06:50MRS. WEIDRE My grandson was born. But I couldn’t go and see him. I still haven’t seen him. My daughter gave birth last week and she’s not going to bring him to see me for several months and I don’t want to wait that long. Diagnostic and Statistical Manual of Mental Disorders Assignment
00:07:10OFF CAMERA You miss out.
00:07:15MRS. WEIDRE Yes! Of course I do! My grandson is a thousand miles away and I can’t leave the God damned house.
00:07:25[sil.]
00:07:25END TRANSCRIPT
About “Training Title 40”
In Test Section Index, Episode 40 (Santa Monica, CA: Symptom Media, 2016), 8 minutes Diagnostic and Statistical Manual of Mental Disorders Assignment

Speculation that diagnosis is Panic Disorder with agoraphobia
Possibly PTSD from loss of her mother. Another possibility is OCD.

Assignment: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD
“Fear,” according to the DSM-5, “is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat” (APA, 2013). All anxiety disorders contain some degree of fear or anxiety symptoms (often in combination with avoidant behaviors), although their causes and severity differ. Trauma-related disorders may also, but not necessarily, contain fear and anxiety symptoms, but their primary distinguishing criterion is exposure to a traumatic event. Diagnostic and Statistical Manual of Mental Disorders Assignment Trauma can occur at any point in life. It might not surprise you to discover that traumatic events are likely to have a greater effect on children than on adults. Early-life traumatic experiences, such as childhood sexual abuse, may influence the physiology of the developing brain. Later in life, there is a chronic hyperarousal of the stress response, making the individual vulnerable to further stress and stress-related disease. Diagnostic and Statistical Manual of Mental Disorders Assignment

For this Assignment, you practice assessing and diagnosing patients with anxiety disorders, PTSD, and OCD. Review the DSM-5 criteria for the disorders within these classifications before you get started, as you will be asked to justify your differential diagnosis with DSM-5 criteria. Diagnostic and Statistical Manual of Mental Disorders Assignment

To Prepare:
• Review this weekâ€s Learning Resources and consider the insights they provide about assessing and diagnosing anxiety, obsessive-compulsive, and trauma- and stressor-related disorders.
• Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document. Diagnostic and Statistical Manual of Mental Disorders Assignment
• By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
• Consider what history would be necessary to collect from this patient. Diagnostic and Statistical Manual of Mental Disorders Assignment
• Consider what interview questions you would need to ask this patient.
• Identify at least three possible differential diagnoses for the patient.
By Day 7 of Week 4
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:
• Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
• Objective: What observations did you make during the psychiatric assessment?  Diagnostic and Statistical Manual of Mental Disorders Assignment
• Assessment: Discuss the patientâ€s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case. Diagnostic and Statistical Manual of Mental Disorders Assignment
• Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

RUBRIC
Create documentation in the Comprehensive Psychiatric Evaluation Template about the patient you selected. Diagnostic and Statistical Manual of Mental Disorders Assignment

In the Subjective section, provide:
• Chief complaint
• History of present illness (HPI)
• Past psychiatric history
• Medication trials and current medications
• Psychotherapy or previous psychiatric diagnosis
• Pertinent substance use, family psychiatric/substance use, social, and medical history Diagnostic and Statistical Manual of Mental Disorders Assignment
• Allergies
• ROS
EXCELLENT
18 (18%) – 20 (20%)
The response thoroughly and accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis.

In the Objective section, provide:
• Physical exam documentation of systems pertinent to the chief complaint, HPI, and history
• Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses. Diagnostic and Statistical Manual of Mental Disorders Assignment
18 (18%) – 20 (20%)
The response thoroughly and accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented.
In the Assessment section, provide:
• Results of the differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.mental status examination, presented in paragraph form. Diagnostic and Statistical Manual of Mental Disorders Assignment
• At least three differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
23 (23%) – 25 (25%)
The response thoroughly and accurately documents the results of the mental status exam. Diagnostic and Statistical Manual of Mental Disorders Assignment

Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides a thorough, accurate, and detailed justification for each of the disorders selected.

Reflect on this case. Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
9 (9%) – 10 (10%)
Reflections are thorough, thoughtful, and demonstrate critical thinking. Diagnostic and Statistical Manual of Mental Disorders Assignment
Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).
14 (14%) – 15 (15%)
The response provides at least three current, evidence-based resources from the literature to support the assessment and diagnosis of the patient in the assigned case study. The resources reflect the latest clinical guidelines and provide strong justification for decision making.
Written Expression and Formatting—Paragraph development and organization: Diagnostic and Statistical Manual of Mental Disorders Assignment
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5 (5%) – 5 (5%)
A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. Diagnostic and Statistical Manual of Mental Disorders Assignment

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

Written Expression and Formatting—English writing standards:
Correct grammar, mechanics, and punctuation
5(5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors Diagnostic and Statistical Manual of Mental Disorders Assignment