Question John is a 25-year-old single, unemployed white man who has

Question John is a 25-year-old single, unemployed white man who has been seeinga psychiatrist for several years for management of psychosis, depression, anxiety, and abuse of marijuana and alcohol.      After an apparently normal childhood, John began to show dysphoric mood, anhedonia, low energy, and social isolation by age 15. At about the same time, John began to drink alcohol and smoke marijuana every day. In addition, he developed recurrent panic attacks, marked by a sudden onset of palpitations, diaphoresis, and thoughts that he was going to die. When he was at his most depressed and panicky, he twice received a combination of Sertraline 100 mg/day and psychotherapy. In both cases, his most intense depressive symptoms lifted within a few weeks, and he discontinued the Sertraline after a few months. Between episodes of severe depression, he was generally seen as sad, irritable, and motivated. His school performance declined around tenth grade and remained marginal through the rest of high school. He did not attend college which had been his parents’ expectation, but instead lived at home and did odd jobs in the neighborhood.      Around age 20, John developed a psychotic episode in which he had the conviction that he had murdered people when he was 6 years old. Although he could not remember who these people were or the circumstances, he was absolutely convinced that it had happened, something that was confirmed by continuous voices accusing him for what happened when he was 6 years old and thus he also feared for his life. Over the next 2 or 3 weeks, he became guilt ridden and preoccupied with the idea that he should kill himself by slashing his wrists, culminating in his being psychiatrically hospitalized because of his parents’ concerns that he would act on these delusions. Although his affect on admission was anxious, within a couple of days he also became very depressed with accompanying symptoms of dysphoria, prominent anhedonia, poor sleep, and decreased appetite and concentration. With the combined use of antipsychotic and antidepressant medications, both the depression and psychotic symptoms remitted after an additional 4 weeks. Thus, the total duration of the psychotic episode was approximately 7 weeks, 4 of which were also characterized by the depressive episode. He was hospitalized with the same pattern of symptoms two additional times before age 22, starting out with a couple of weeks of delusions and hallucinations related to his conviction that he had murdered someone when he was a child, followed by severe depression lasting an additional month. Both of those relapses occurred while he was apparently adhering to reasonable dosages of antipsychotic medication. For the past 3 years, John has been adherent to Clozapine and has been without any further episodes of hallucinations, delusions or depression.      John began to abuse marijuana and alcohol at age 15. Before the onset of psychosis at age 20, he smoked several joints of marijuana almost daily and binge drank on weekends with occasional blackouts. After the onset of psychosis, his marijuana use decreased significantly, yet he continued to have two more psychotic episodes through age 22 (as described above). He started attending Alcoholics Anonymous and Narcotics Anonymous groups, achieved sobriety from marijuana and alcohol at age 23, and has since remained sober.Formulate 3 differential diagnoses, probable diagnoses, and definitive diagnoses. Health Science Science Nursing NRNP 6635 Share QuestionEmailCopy link Comments (0)

Having Trouble Meeting Your Deadline?

Get your assignment on Question John is a 25-year-old single, unemployed white man who has completed on time. avoid delay and – ORDER NOW

Do My Paper

Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Order Now and we will direct you to our Order Page at Litessays. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.