Neurocognitive and Neurodevelopmental Disorders

Case Study

Name: Harold Brown

Gender: male

Age:60 years old

T- 98.8 P- 74 R 18 134/70 Ht 510 Wt 170lbs

Background:

Has bachelor degree in engineering. He dates casually, never married, and has no children. Has one younger brother. Sleeps 7 hours, appetite good. Denied legal issues; MOCA 28/30 difficulty with attention and delayed recall; ASRS-5 21/24; denied hx of drug use; enjoys one scotch drink on the weekends with a cigar. Allergies Diluted; history HTN blood pressure controlled with Cozaar 100mg daily, angina prescribed ASA 81mg po daily, valsartan 80mg daily.

Hypertriglyceridemia prescribed fenofibrate 160mg daily, has BPH prescribed tamsulosin 0.4mg po bedtime. Neurocognitive and Neurodevelopmental Disorders

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Harrold is a 60-year-old male in the unit for evaluation due to concentration difficulties while performing daily routines. He admitted working in huge architectural engineering, and all has been well, except for the current acceleration of deadlines, which puts much strain on him. He claims he cannot concentrate as other workers adjust to the new rules. He admits to making silly errors that he would not have made in the past. He claims that one careless error he made was designing an air duct through a solid wall, firewall, and supporting wall without even realizing what he was doing. If his plan had been implemented, the windows he created might have cost millions. He asserts that he didn’t have this problem when things were more laid back and deadlines were common. He complains about being unable to accomplish tasks as quickly as everyone else due to the absurdly short deadlines. He admitted to having focus issues in school, and when studying for an exam at the library, he ended up staring out the window rather than reading.

He also claims to have trouble paying attention during group lectures since his thoughts are constantly on himself while others strive to figure out the group's objectives. While listening to the lectures, he considers things other than what is being said, such as whether his dog needs to be bathed, what treatment he will have for his lung, or anything else. He struggles with the organization since he tends to be disorganized, forgetting things like his shoes, phone, and jacket and having trouble finding them. He admits to being hyperactive because he occasionally feels uncomfortable in a chair. In school, where he had low scores for citizenship because he never raised his hand, spoke outside of class, and found it difficult to pay attention, he maintained that his conduct was worse. Despite her mother's threats to have him evaluated, he refused to be treated for ADHD with drugs or other therapies. He claims to consume caffeinated beverages like soda and coffee without adding sugar.

Assignment

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? Neurocognitive and Neurodevelopmental Disorders

objective: What observations did you make during the psychiatric assessment?

Assessment: Discuss the patient 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-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR 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.

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.).

Neurocognitive and Neurodevelopmental Disorders