peer review (V) Bipolar case scenario
The presentation will highlight the case of A.D. encountered in the clinical setting with signs and symptoms of both psychiatric disorders and a medical condition as well. She also has breathing difficulties following a long battle with Asthma and recently contracting COVID-19. A.D. is a 62-year-old Hispanic female with a history of major depressive disorder. The patient stated her husband of 30 years passed away last year and it has been difficult to cope. She mentions that the couple had two children who are now married and live in other states. She lives alone in a 3-bedroom apartment and have few friends and family that comes to visit her. The patient said she gets about 7 hours of sleep daily with the help of her sleeping medication. A.D. came to the psychiatric center for a follow-up appointment and prescription medication refill. She also has trouble falling asleep without use of her prescribed sleeping medication. A.D: 62-year-old Hispanic female seen for a follow-up visit for Bipolar 1 Disorder. The visit was attended by the patient alone.; history obtained from patient. Current Medications: Cymbalta 30mg PO Daily.
Appearance: Neat and well-groomed Mood: Admits to feeling sad – still grieving death of her husband. Admits to exhaustion – despite 7 hours of undisturbed sleep after taking her Ambien 5mg. Appeared restless – changing her position while sitting in the chair.Ruminating: making statements of not wanting to stay too long and voicing worry if her transportation is waiting outside for her. Admits to feeling fearful of being home alone. Daughter will be arriving at her apartment in 2 hours.
Bipolar screening tools have been developed so that they are easy to use and can ensure the correct diagnosis. The tools used to diagnose bipolar are designed as a semi-structured interview. This means that the interview will not necessarily follow a set list of questions, but will include open-ended questions and discussion. Examples of these tools include the Structured Clinical Interview for DSM-5 (SCID) and the Schedule for Affective Disorders and Schizophrenia (SADS).
