ADINNU-BHETWAL-BRAVO-BUHAYO-MERCADO-MOODLEY-PEÑA-SAUÑA-TIU-TROMPETA-VILLANUEVA
PEÑA
Case:
MJ is a 22 yr old male student who was brought to the hospital one night by
his dorm guardian. He has no psychiatric history but has been having difficulty
coping in class and often worried about his grades. He had recently received a
failing score for his first long exam that day. Last night during dinner, his
guardian noticed fresh blood on his shirt sleeves. The guardian noticed scars
on his left arm and fresh blood from a recent cut. His guardian was worried
and brought him to the hospital. You are assigned in the emergency room and
saw the patient.
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PEÑA
Pertinent data:
- 22 years old/ Male
- No psychiatric history
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GUIDE QUESTIONS
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PEÑA
● Accidental Wound
● Self-inflicted wound
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PEÑA
First Aid
Anti-tetanus
Antibiotics
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PEÑA
Ask open ended questions followed by clarification while
inspecting the arm
● This will help identify the real cause of the wound/cut
● Maintain eye contact and be in a relaxed position
● Do active listening
● Build rapport
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PEÑA
·How or what are you feeling right now?
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SAUÑA
*Ask the patient if he has had any suicidal thoughts and
depending on the answer we can proceed to additional
questions.
· What is or are the things that’s troubling you?
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SAUÑA
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BUHAYO
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BUHAYO
Confidence
- Refers to the state-of-the-art medical
practices wherein experience in treating
specific medical conditions or performing
procedures is exuded by the physician’s
manner of speaking
Empathetic
- Physician makes eye contact with the
patient as well as the family members,
and correctly interprets patient’s
verbal and non-verbal cues
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BUHAYO
Humane
- Physician uses appropriate
physical contact, and is
attentive; He or she shows
willingness to spend adequate
time with the patient through
unhurried movements
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BUHAYO
Personal
- Physician asks patient about
their lives, discusses own
personal interests, uses
appropriate humor, and
acknowledges the patient’s
family
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BUHAYO
Forthright
- Physician doesn’t sugarcoat or
withhold information and does
not use medical jargon
- Physician is capable of
explaining the pros and cons of
the treatment
Respectful
- Physician offers explanation or apology
if the patient is kept waiting
Thorough
- Physician provides detailed
explanations, gives
instructions in writing,
follows a timely manner,
and expresses to the
patient the desire to consult
other clinicians or research
literature on a difficult case
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ADINNU
3. What will you do?
A. Approach the patient
B. Probe
C. Reflective listening
D. Assess for patient’s disposition
E. Further history taking
F. Request for laboratory exam
G. Refer to psychiatrist for proper evaluation and management
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BHETWAL
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BHETWAL
The first step in getting help is talking to a trusted adult, friend or medical
professional, a psychiatrist. A doctor will also recommend therapy to help a
person learn new behaviors, if self-injury has become a habit.
● Psychodynamic therapy focuses on exploring past experiences and
emotions
● Cognitive behavioral therapy focuses on recognizing negative thought
patterns and increasing coping skills
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TIU
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TIU
Pp 286-287 American Psychiatric Association. (2013). Diagnostic and Statistical Manual of mental disorders (5th ed.). 25
TIU
Criteria and History
❏ Stress-related disturbance does not meet the criteria for another mental
disorder and is not merely an exacerbation of a preexisting mental disorder
❏ No psychiatric history
Pp 286-288 American Psychiatric Association. (2013). Diagnostic and Statistical Manual of mental disorders (5th ed.). 26
TIU
Subtype
❖ With depressed mood
➢ Low mood, tearfulness, or feelings of hopelessness
❖ With anxiety
➢ Nervousness, worry, jitteriness, or separation anxiety
❖ With mixed anxiety and depressed mood
❖ With disturbance of conduct
leads to infringement on others’ rights, or rebellion against normal rules of
conduct.
❖ With mixed disturbance of emotions and conduct
❖ Unspecified (does not fit any of the above)
P.287 American Psychiatric Association. (2013). Diagnostic and Statistical Manual of mental disorders (5th ed.). 27
RULE OUT
BRAVO
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BRAVO
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BRAVO
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of mental disorders (5th ed.). 30
BRAVO
● Criterion symptoms for major depressive disorder must be present nearly every
day to be considered present
● Essential feature: Depressed mood or the loss of interest or pleasure in nearly
all activities (at least 2 weeks)
● The mood in a major depressive episode is often described by the person as
depressed, sad, hopeless, discouraged, or "down in the dumps
● Loss of interest or pleasure is nearly always present. Report feeling less
interested in hobbies, "not caring anymore," or not feeling any enjoyment in
activities that were previously considered pleasurable
● Sleep disturbance may take the form of either difficulty sleeping or sleeping
excessively
● The sense of worthlessness or guilt associated with a major depressive episode
may include unrealistic negative evaluations of one's worth
Pp 160-168 American Psychiatric Association. (2013). Diagnostic and Statistical Manual of mental disorders (5th ed.). 31
BRAVO
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MOODLEY
●Therapist can work with the patient’s negative thought pattern and irrational
beliefs
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MOODLEY
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MOODLEY
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MOODLEY
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MOODLEY
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MOODLEY
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ADINNU
Medication
●Benzodiazepines
●Nonbenzodiazepine anxiolytic
○Gabapentin
●SSRI or SNRI
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