Case Study For Anxiety Panic Attack Assessment And Diagnosis

Case Study For Anxiety Panic Attack Assessment And Diagnosis

Introduction

Assessing and diagnosing patients with disorders is an essential component of clinical practice. This paper explores the assessment and diagnosis process of 21 years old client named Mr. Luca Esposito. Clinical assessment for most mental and psychosocial disorders is challenging because they often present with heterogeneous and overlapping symptoms. This problem calls for a dimensional classification that integrates diverse aspects of neurobiological and psychological circuits. In contemporary health care practice, assessment and diagnosis of mental or psychiatric disorders are substantially grounded on DSM criteria for classifying and characterization symptoms. However, there is a need to integrate diverse approaches, such as molecular circuits and genetics, into conventional models of assessment such as DSM as part of the assessment Case Study For Anxiety Panic Attack Assessment And Diagnosis.

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Subjective: 

Chief complaint: Panic

The client reported difficulty breathing, accompanied by increased sweating, pounding heartbeat, and palpitations (heart leaping out of chest)Case Study For Anxiety Panic Attack Assessment And Diagnosis. The client reports that complaints occur about 12- 15 minutes and disappear. Mr. Luca Esposito says that this complaint related to panic has no specific cause. He feels that symptoms are making him uncomfortable. Thus, the current complaint has not affected social or life functioning.

Mr. Luca Esposito resides alone in Orlando. His parents raised him in Buffalo, NY, as an only child.Currently, he is a full-time student studying for a degree in graphic design. He works part-time as an Uber driver. Socially, he has a girlfriend from high school. He denies the use of drugs and alcohol. His part medical and surgical history is non-contributory. There is no history of medical illnesses or psychiatric treatment. He has no known allergies. Finally, he sleeps 6 hours, eats three meals daily, and has a regular schedule.

Objective

Mr. Luca Esposito is well dressed and has a perfect orientation to time, place and situation. General physical information is remarkably good. His general appearance was appropriate. He appears youthful and clean and communicates well, verbally or non-verbally. In terms of affect, or emotional state, he depicts appropriate congruency. He does not exhibit strange, violent, threatening, suicidal, self-injurious, or violent behaviour. Specific systemic assessment findings are within normal limits (WNL)Case Study For Anxiety Panic Attack Assessment And Diagnosis.

Vital signs: Temperature 97.4: heart rate 112: Respiratory rate 22: Blood pressure 122/68: Ht 6’1Wt 198lbs

Assessment

Based on the presentation and complaints, the client could be suffering from panic attacks. Panic disorder does have positive results during the mental status examination (MSE). The patient may or may not appear anxious during assessment or interviews. The assessment results are drawn from Mini-Mental Status Examination, including memory tests, proverb interpretation and cognitive performance, which are often intact and consistent (Kelso & Tadi,2021). Observations from MSE correspond to the patient’s educational level and intellectual functioning. However, assessment of the patient’s complaints points to anxiety and panic attacks. The DSM-5 provides a critical framework that guides the assessment and diagnosis of panic disorder. First, Panic disorder is recurring unexpected/sudden panic attacks marked by an abrupt surge of intense fear. Such intense discomfort peaks within minutes. The DSM-5 lists at least four symptoms: palpitations (pounding heart/accelerated heart rate), sweating, trembling or shaking. It is also manifested by sensations of shortness of breath or smothering, and feelings of choking (Kim,2019)Case Study For Anxiety Panic Attack Assessment And Diagnosis. This spectrum of symptoms can also include chest pain/discomfort, dizziness, heat sensations /chills paresthesias (numbness or tingling sensations), Derealization or depersonalization and fear of dying (Brown et al.2016). Panic attacks happen severally each day. It can also occur infrequently, such as having a few attacks annually. However, its hallmark feature is that panic disorder tends to occur without warning, with no specific trigger. Thus, patients with panic disorder lack self-perceived a lack of control.

Mr. Luca Esposito reported at least four of these symptoms. He reported complaints of increased difficulty in breathing, accompanied by increased sweating, pounding heartbeat, palpitations (heart leaping out of chest) and ‘a feeling like dying”. The client reports that complaints occur for about 12- 15 minutes and disappear. Second, at least one attack should have occurred a minimum of a month ago, with ensuing maladaptive change in behaviour associated with the attacks. For instance, avoidance of situations that can exacerbate panic attacks is part of maladaptive behaviours. Third, such disturbance should not be associated or linked to physiological effects of drugs and substances or medical illness. For instance, drug abuse could contribute to symptoms that bear remembrance of a panic attack. Since Mr. Luca Esposito reported no history of abuse of drugs or drinking, his symptoms may not attribute to substance abuse-related disorders. Furthermore, he has no history of medical conditions such as hyperthyroidism and cardiopulmonary disorders that could explain the current symptoms. Finally, according to DSM-5, the disturbance should not be directly explained by a specified mental disorder (Brown et al.2016). For instance, panic attacks do not happen due to feared social situations or in response to phobic objects or situations (Cackovic, Nazir, & Marwaha, 2017)Case Study For Anxiety Panic Attack Assessment And Diagnosis. Thus, the primary diagnosis, in this case, is a panic attack.

During the assessment, differential diagnoses should be considered. Panic attacks can occur alongside other anxiety, psychotic, mood and substance use disorders. Thus, making an accurate diagnosis of the panic disorder requires differentiation from other potential diagnoses (Cackovic, Nazir, & Marwaha, 2017). Even though panic attacks may be traced to direct effects of substance use, treatment, or a medical condition such as hyperthyroidism, the panic disorder should not be directed attributed to these causes as sole reasons. Some of the differential diagnoses include generalized anxiety disorder, thyrotoxicosis, arrhythmia, drug withdrawal symptoms (alcohol, opioids, benzodiazepines and antidepressants), anaemia, obstructive pulmonary diseases, Asthma, ARDS, Posttraumatic stress disorder (PTSD)Case Study For Anxiety Panic Attack Assessment And Diagnosis, somatoform disorder, bipolar disorder and obsessive-compulsive disorder. However, based on the history of the patient, most of this differential diagnosis will be ruled out. Since Mr. Luca Esposito had no significant history surrounding past medical, surgical and mental history, as well as the absence of drug/alcohol abuse, most of this differential diagnosis could easily be ruled out. The ECG report also ruled out any potential cardiovascular disorders such as arrhythmias. Thus, the primary diagnosis for Mr. Luca Esposito is a panic attack. This diagnosis is arrived at by evaluating both Objective and subjective information within the context of complaints, symptomatic presentation and the DSM-5 framework. The positive aspect of this case is that the panic attack has not disrupted the client’s functionality. The specific client case’s negatives involve a panic attack’s negative effects such as sweating and palpitation.

Reflection

What could be done differently for this patient involves assessing more data on the frequency of symptoms. The patient could also be asked about the risks that expose him to a panic attack. The discussion should also seek to establish whether panic attacks have significantly impacted his life. Ethical practices must also be equally considered in this case. Critical ethical issues may arise in this case, mainly when collating all relevant information. For instance, asking the client about the socio-economic background of his parents raise confidentiality, consent and privacy issues because the clients reveal data about parents who have not provided any consent for such information Case Study For Anxiety Panic Attack Assessment And Diagnosis.

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References

Brown, L. A., LeBeau, R., Liao, B., Niles, A. N., Glenn, D., & Craske, M. G. (2016). A comparison of the nature and correlates of panic attacks in the context of Panic Disorder and Social Anxiety Disorder. Psychiatry research, 235, 69-76.

Cackovic, C., Nazir, S., & Marwaha, R. (2017). Panic disorder (attack).

Kelso, I. G., & Tadi, P. (2021). Cognitive Assessment. In StatPearls [Internet]. StatPearls Publishing.

Kim, Y. K. (2019). Panic Disorder: current Research and management approaches. Psychiatry Investigation, 16(1), 1. Case Study For Anxiety Panic Attack Assessment And Diagnosis