Diagnosis Of Anxiety And Obsessive-Compulsive And Related Di ✓ Solved

Diagnosis of Anxiety and Obsessive Compulsive and Related Disorders

In this discussion, I will analyze a client presenting with symptoms indicative of an anxiety disorder, utilizing the DSM-5 criteria for accurate diagnosis. I will outline the full DSM-5 diagnosis, including the disorder name, ICD-10-CM code, relevant specifiers, severity level, and Z codes that may be applicable. Additionally, I will justify how the client's symptoms align with specific diagnostic criteria, consider and eliminate differential diagnoses, describe an assessment tool for ongoing validation, and recommend an evidence-based intervention supported by scholarly research.

Considering the client's reported symptoms such as persistent worry, restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances over the past 12 months, the most fitting diagnosis appears to be Generalized Anxiety Disorder (GAD). According to the DSM-5 (American Psychiatric Association, 2013), GAD is characterized by excessive anxiety and worry occurring more days than not for at least six months, about multiple events or activities. The anxiety is difficult to control and is associated with three or more symptoms from the DSM-5 criteria: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, or sleep disturbance.

The ICD-10-CM code for Generalized Anxiety Disorder is F41.1. The severity can be classified based on the impact on functioning and the intensity of symptoms, ranging from mild to severe. Since the client reports significant impairments, a moderate to severe classification may be appropriate. Z codes such as Z63.4 (Disappearance and death of family member) or Z72.821 (Emotionally unstable personality traits) could be considered for contextual or co-occurring factors affecting the condition.

The client's symptoms closely match the diagnostic criteria: ongoing worry about multiple areas of life, physical symptoms of tension, and sleep issues. Differential diagnoses considered include panic disorder, social anxiety disorder, and obsessive-compulsive disorder (OCD). However, the absence of discrete panic attacks, specific phobias, or compulsive rituals led to the exclusion of these disorders. For example, OCD involves recurrent obsessions and compulsions, which the client did not report, and social anxiety is characterized by fear of social situations specifically, rather than generalized worry.

For ongoing assessment, the Generalized Anxiety Disorder 7-item scale (GAD-7) provides a validated, reliable measure of severity and symptom change over time (Spitzer et al., 2006). This self-report questionnaire helps in monitoring treatment progress and adjusting interventions accordingly.

Regarding treatment, cognitive-behavioral therapy (CBT) is supported by robust evidence for effectiveness in GAD (Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012). CBT strategies such as cognitive restructuring and relaxation techniques target maladaptive thought patterns and physiological symptoms. Pharmacotherapy with selective serotonin reuptake inhibitors (SSRIs) is also effective, either alone or combined with therapy. The choice of intervention should be tailored to the client's preferences, history, and co-occurring conditions.

In conclusion, a comprehensive diagnosis incorporating DSM-5 criteria, assessment tools, differential diagnosis reasoning, and evidence-based interventions ensures a holistic approach to managing anxiety. Accurate diagnosis enables targeted treatment, improves client outcomes, and facilitates ongoing monitoring of progress in mental health care settings.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
• Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440. https://doi.org/10.1007/s10608-012-9476-1
• Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092
• American Psychiatric Association. (2013). Glossary of cultural concepts of distress. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. https://doi.org/10.1176/appi.books..GlossaryofCulturalConceptsofDistress
• Diáz, E., Añez, L. M., Silva, M., Paris, M., & Davidson, L. (2017). Using the cultural formulation interview to build culturally sensitive services. Psychiatric Services, 68(2), 112–114. https://doi.org/10.1176/appi.ps.201600334
• Dominguez, M. L. (2017). LGBTQIA people of color: Utilizing the cultural psychology model as a guide for the mental health assessment and treatment of patients with diverse identities. Journal of Gay & Lesbian Mental Health, 21(3), 203–220. https://doi.org/10.1080/19359705.2016.1153702
• Morrison, J. (2014). Diagnosis made easier (2nd ed.). Guilford Press.
• Document: How to record in Collaborate Ultra (PDF).
• Required media TEDx Talks. (2015, May 29). Living with #OCD | Samantha Pena | TEDxYouth@TCS [Video file]. Retrieved from https://www.youtube.com/watch?v=XXXX
• TEDx Talks. (2016a, October 11). My hidden OCD exposed | Anne Swanson | TEDxVermilionStreet [Video file]. Retrieved from https://www.youtube.com/watch?v=YYYY