Brain Damage and Psychiatric Diagnostic Assessment

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Major Psychiatric Disorder(s): F90.2 Attention-Deficit/Hyperactivity Disorder (combined presentation)

The client is a 23-year-old female who came to a hospital and cannot even remember why she came here. She does not feel that something goes wrong with her and that she may have some problems. At the same time, she reports on her poor concentration and poor memory. She does not like to wait in line or answer many questions. She has to move and change something. Her intentions to move constantly annoy people around. Such behavior proves that the client may have attention-deficit/hyperactivity disorder (ADHD). The client meets criterion A1, an inattention pattern.

For example, she has difficulties while sustaining attention in tasks (A-1-a) when she missed counted some money as a bank worker (American Psychiatric Association, 2013). She does not listen when people speak to her directly during interviews (A-1-c) and does not like to wait. The client admits that she loses her wallet five times per week (A-1-g). She is easily distracted and changes topics frequently, and such behavior meets the criterion A-1-h (American Psychiatric Association, 2013). Finally, she avoids her engagement in tasks, explaining that she cannot do something (A-1-f). At the same time, the client meets criterion A2, hyperactivity and impulsivity (American Psychiatric Association, 2013). She leaves her seat when she is expected to sit (A-2-b), talks excessively (A-2-f), cannot wait her turn (A-2-h), and feels restless (A-2-e).

Developmental Disorder(s): F82. Developmental Coordination Disorder

This diagnosis may be based on the fact that the client cannot sit when it is expected, proving that her motor performance is substantially below the expected level – criterion A (American Psychiatric Association, 2013). Also, such coordination disturbance considerably influences her daily activities and relationships with other people – criterion B. Finally, the client says that she could not remember when everything began. It could begin when she was younger, meaning that some symptoms appeared in the early developmental period – criterion C.

Personality Disorder(s): F60.9 Unspecified Personality Disorder

The choice of this diagnosis may be explained by the fact that the client is obsessed with the necessity to move fast and change the things around. Such characteristics prove that some personality disorder traits may be observed. However, the client does not meet the full criteria for one disorder.

Medical Disorder(s): Brain Damage

This diagnosis is possible because the client suffers from memory loss, poor concentration, and a short attention span that are the symptoms of a brain injury. It is hard to clarify the causes of this medical problem. Certain diagnostic tools, e.g., MRI, should be chosen to prove this damage.

Client Strengths

The client went to high school.
The client had a job.
The client develops good relations with her family.
The client has the energy to be occupied with several tasks.
The client understands that she can annoy people.
The client does not have any medical issues.
The client does not have any alcohol problems.
The client does not have bad eating habits.
The client is not suicidal.

Comments/Differential Diagnosis

The client may have insomnia disorder because she says that she barely sleeps and feels tired. Her inability to sleep properly may cause her behavioral changes and her feeling of being the energizer bunny. Also, anxiety and depression may be the causes of her behavioral changes and the necessity to be in a hurry to not identify other problems and obligations. She loses things, cannot be complete tasks, and does not want to wait. Such behavior is an example of anxiety disorder.

Reference

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5^th ed.). Washington, DC: American Psychiatric Publishing.

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