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Analyze the five case studies provided, applying the DSM-5 criteria to identify the most appropriate diagnoses for each individual. Use comprehensive understanding of DSM-5 diagnostic categories, features, and differential diagnoses to synthesize and evaluate each case, providing in-depth reasoning behind each conclusion. Consider the presenting symptoms, behavioral patterns, history, and contextual factors to determine the primary mental health disorder or disorders affecting each person, supported by DSM-5 diagnostic guidelines.

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Louise, a 35-year-old woman, exhibits symptoms consistent with a hypomanic episode, characterized by an elevated mood, decreased need for sleep, and increased activity, notably shopping impulsively and spending money she normally would avoid. Importantly, she maintains functional capacity—working and caring for her children—without delusions or hallucinations, and her mood during evaluation is notably elevated without evidence of psychosis or depression. According to DSM-5 criteria, her symptoms align with Bipolar II Disorder, particularly the hypomanic episode, as her symptoms are markedly abnormal for her, cause observable change in functioning, but do not cause significant impairment or psychosis (American Psychiatric Association, 2013). Her denial of negative consequences and the onset of symptoms following a stressful period support this diagnosis. Further monitoring would be necessary to confirm the recurrence of hypomanic episodes or progression to bipolar disorder.

Carl, a 50-year-old man, displays pervasive distrust and suspiciousness without delusions or hallucinations, consistent with a diagnosis of Paranoid Personality Disorder (PPD). DSM-5 specifies that individuals with PPD primarily distrust others, are enduring patterns, and show suspicion across contexts, often interpreting benign behaviors as malevolent. His history of long-standing distrust, difficulty trusting friends, and retaliatory anger when betrayed are characteristic features. The absence of psychotic symptoms suggests that this is a personality disorder rather than delusional disorder. The chronicity and pervasive nature of his suspiciousness, along with the absence of hallucinations, support a diagnosis of PPD (American Psychiatric Association, 2013). Counseling or therapy focusing on trust development could benefit, but the rigid pattern suggests ongoing personality pathology.

Judy, a 16-year-old girl, reports recurrent stealing driven by an irresistible urge, experiencing a “rush” when stealing, with no other behavioral issues noted. DSM-5 classifies this behavior as Kleptomania, a disruptive, impulse-control disorder characterized by recurrent failure to resist impulses to steal objects, which are not needed for personal use or monetary value, and which cause significant distress or impairment (American Psychiatric Association, 2013). Her insight into the impulsivity and the emotional relief she experiences from stealing corroborate this diagnosis. Her lack of other conduct problems suggests specific kleptomania rather than conduct disorder. Treatment options include cognitive-behavioral therapy and mood stabilization interventions to manage impulse control.

Tina, a 30-year-old woman, presents with recurrent suicidal ideation, self-harm, unstable relationships, and emotional dysregulation, features consistent with Borderline Personality Disorder (BPD). DSM-5 criteria include frantic efforts to avoid abandonment, unstable interpersonal relationships, identity disturbance, impulsivity, and recurrent suicidal behavior or self-mutilation. Her history of sexual abuse and promiscuity further support the diagnosis, as trauma history is often associated with BPD. Her cyclical relationship patterns, intense fears of abandonment, and self-harming behaviors suggest pervasive emotion dysregulation characteristic of BPD (American Psychiatric Association, 2013). A structured psychotherapy, such as dialectical behavior therapy, is indicated to improve emotional regulation.

Angela, a 50-year-old woman, demonstrates a dependent personality style, evidenced by her excessive reliance on others for decision-making, fear of being alone, and submissive tendencies. DSM-5 defines Dependent Personality Disorder by a pervasive and excessive need to be taken care of, leading to submissiveness and fears of separation. Angela’s lack of independent decision-making, low self-confidence, and obsession with avoiding abandonment align with this diagnosis. Her normal cognition and absence of psychosis affirm her personality structure without other comorbidities. Psychotherapeutic interventions aiming to promote independence and self-esteem are recommended, though her long-standing dependency complicates treatment (American Psychiatric Association, 2013).

References

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