< 4:02 ll 50% Nancy Ingram, a 33-year-old stock analyst and married mother of two children, was brought to the emergency

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4 02 Ll 50 Nancy Ingram A 33 Year Old Stock Analyst And Married Mother Of Two Children Was Brought To The Emergency 1 (63.25 KiB) Viewed 59 times

< 4:02 ll 50% Nancy Ingram, a 33-year-old stock analyst and married mother of two children, was brought to the emergency room (ER) after 10 days of what her husband described as "another cycle of depression, marked by a hair-trigger temper, tearfulness, and almost no sleep. He noted that these "dark periods had gone on as long as he had known her but that she had experienced at least a half dozen of these episodes in the prior year. He said they typically improved within a few weeks of restarting her fluoxetine. He added that he wondered whether alcohol and clonazepam worsened her symptoms because she routinely ramped up their use when the dark periods began. Ms. Ingram's husband said he had decided to bring her to the ER after he discovered that she had recently created a blog entitled Ms. Ingram's Best Stock Picks. Such an activity not only was out of character but, given her job as a stock analyst for a large investment bank, was strictly against company policy. He said that she had been working on these stock picks around the clock, forgoing her own meals as well as her responsibilities at work and with her children. She countered that she was fine and that her blog would "make them as rich as Croesus." On examination, the patient was pacing angrily in the exam room. She was dressed in jeans and a shirt that was carelessly unbuttoned. Her eyes appeared glazed and unfocused. She responded to the examiner's entrance by sitting down and explaining that this was all a miscommunication, that she was fine and needed to get home immediately to tend to her business. Her speech was rapid, pressured, and very difficult to interrupt. She admitted to not sleeping but denied that it was a problem. She denied hallucinations but admitted, with a smile, to a unique ability to predict the stock market. She refused cognitive testing, saying she would decline the opportunity to be a "trained seal, a guinea pig. Mr. Ed, and a barking dog, thank you very much, and may I leave now?" Her insight into her situation appeared poor, and her judgment was deemed to be impaired. Questions 1. What diagnosis from the DSM-5 would Nancy meet criteria? b. Using the DSM-5 list all the criteria from the diagnos chosen that Nancy is experiencing. Provide a rationale you selected this diagnosis by highlighting all of Nancy's behavior that matched the symptom criteria from the DSM-5