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- May 23, 2008
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I am a first year masters student and I need help with a diagnosis for this vignette:
Melissa, a 41 year-old lab technician , has been referred to you for treatment by her physician because of her "severe psychological symptoms.
During your first session Melissa tells you that she has been feeling anxious and depressed for the last 3 months because she fears that she might involuntarily urinate in public. She has trouble sleeping and has no energy during the day. In addition, she has lost her appetite, but she did not loose weight.
Even though she has never urinated in public, the fear dominates her thinking. ONly at home does she feel normal and consider nonsensical the idea that she will actually lose control. Outside her home Melissa takes many precautions. She always wears sanitary napkins, never travels far away from home, limits her intake of fluids, and stopped drinking alcohol. At her workplace she has located her desk close to the bathroom. For the last 2 weeks she has been unable to work because the fear has become so intense.
In revealing her history, Melissa tells you that she was hospitalized 10 years ago because she thought that she had contracted syphilis. Since there was no evidence of an infection, she was released. Before 3 months ago, Melissa had never had a fear that she might urinate in public.
According to Melissa her family considers her an insecure, overly cautious, anxious, and perfectionist person. She was married in the past and now lives as a single mother with her 5-year-old son and her mother. Mother disapproves of her boyfriend and Melissa feels pressure to end the relationship. She believes that the onset of her fear coincides with the increased stress to her relationship with Mom and the fact that her boyfriend, a 43-year-old reporter, is about to return to his home country in Europe.
The DX that I have come up with so far are Specific Phobia, Other Type and Adjustment Disorder. I am not sure about this particular vignette. I do not necessarily want the answer, but any information or hints that will lead me to the correct DX would be helpful! Thanks.
Melissa, a 41 year-old lab technician , has been referred to you for treatment by her physician because of her "severe psychological symptoms.
During your first session Melissa tells you that she has been feeling anxious and depressed for the last 3 months because she fears that she might involuntarily urinate in public. She has trouble sleeping and has no energy during the day. In addition, she has lost her appetite, but she did not loose weight.
Even though she has never urinated in public, the fear dominates her thinking. ONly at home does she feel normal and consider nonsensical the idea that she will actually lose control. Outside her home Melissa takes many precautions. She always wears sanitary napkins, never travels far away from home, limits her intake of fluids, and stopped drinking alcohol. At her workplace she has located her desk close to the bathroom. For the last 2 weeks she has been unable to work because the fear has become so intense.
In revealing her history, Melissa tells you that she was hospitalized 10 years ago because she thought that she had contracted syphilis. Since there was no evidence of an infection, she was released. Before 3 months ago, Melissa had never had a fear that she might urinate in public.
According to Melissa her family considers her an insecure, overly cautious, anxious, and perfectionist person. She was married in the past and now lives as a single mother with her 5-year-old son and her mother. Mother disapproves of her boyfriend and Melissa feels pressure to end the relationship. She believes that the onset of her fear coincides with the increased stress to her relationship with Mom and the fact that her boyfriend, a 43-year-old reporter, is about to return to his home country in Europe.
The DX that I have come up with so far are Specific Phobia, Other Type and Adjustment Disorder. I am not sure about this particular vignette. I do not necessarily want the answer, but any information or hints that will lead me to the correct DX would be helpful! Thanks.
