Mental and psychiatric illnesses have are on a rise especially with the dynamism in social, economic and even political changes. These factors have made people liable to mental conditions. This paper will review the diagnosis using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) classification and justify the diagnosis. The paper will also outline a case formulation.
PART 1-DIAGNOSIS BASED ON DSM-IV-TR
Robert Jones clearly shows a clinical mental disorder and other clinical conditions that require further medical attention. On the basis of the multiaxial assessment of the mental illness, Robert is an alcoholic who clearly depends on alcohol. Alcohol as a drug is the most commonly abused drug. Alcohol depresses the central nervous system and alters the mood of an individual. These effects of alcohol make it a psychoactive drug. Robert Jones is arrested by the police and has a BAC of 20. BAC refers to the Blood Alcohol Concentration. It is an expression of alcohol to blood in percentile. According to the Tennessee review journal, the acceptable level of alcohol intoxication is 10. The level of BAC reflects on the level of alcohol impairment and psychoactive effects. According to the survey by the US department of health, a BAC of 20 indicates a confused person who requires support in performing tasks. This is the level that is responsible for the average alcohol-related accidents. Based on the multiaxial assessment, the diagnosis is Axis 1- alcohol dependence with physiological dependence.
PART II-JUSTIFICATION FOR THE DIAGNOSIS
The diagnosis identified for Robert Jones is Axis 1-alcohol dependence with physiological dependence. Alcohol being a psychoactive drug, its effects become manifested when a patient has a high amount of alcohol intoxication. The legal level of intoxication according to the United States Health department is a Blood Alcohol Concentration of 20. Robert Jones is found to have this level of alcohol. The features of mental illness such as hallucination are detected in Robert. Robert does not know while he was in the clinic. Most of the mentally ill patients always deny having any illness just like Robert. Robert has grandiosity and so many ideas. He already imagines his teenage daughter driving. Robert is clearly confused and lacks awareness of place. He refers to his Blood Alcohol Concentration as his “bar” and also does not know where he is. Robert admits that he had been drinking for more than 30 years, and the wife had told him to stop but he has always struggled with it. He promises to stop but again reveals that he is unable. The other possible diagnosis would be schizophrenia because Robert was an African American (they are more liable to having this condition) and had loosening of associations, emotional disturbances and withdrawal into his inner world. What helped eliminate schizophrenia is because Robert does not have bizarre behavior and also the level of hallucination is low. Axis IV, marital issues and legal involvement could have been a possible diagnosis, but it has not been so critical to affect his life. Marital issues should involve major events such as divorce while legal involvement should involve major events such as jail term.
PART III-WRITING THE CASE FORMULATION
In the case formulation for Robert Jones, the best theory that explains the development of his problems is the humanistic theory. The tenets of the humanistic theory such as unique existence of a human being, a human being supersedes the sum of his parts, human beings are aware, and the aim that human beings hold underscores the genesis of problems facing Robert Jones. Robert Jones is aware that alcoholism is harmful to his body. He is also aware of himself in the context of people such as police officers and the health care professionals. Robert is faced with a decision to make a choice between alcoholism and a healthy living. He irresponsibly opts to continue being an alcoholic, yet he forgets that his future is at stake. The domestic issues with his wife over issues of alcoholism persist. Robert Jones problems developed as a result of him ignoring the responsibility and awareness bestowed upon him. Robert had lost the values and meaningfulness attached to life. According to the Journal on alcohol as a psychoactive drug, alcoholics are not responsible, and their primary concern is satisfaction of their drinking habits. The core of the humanistic theory is that people have a choice to make which is pegged to responsibility.
References
Cowen, P., Burns, T., & Harrison, P. (2012). Shorter Oxford Textbook of Psychiatry. London: Oxford University Press.
Oldemeyer, L. N. (2009). Demographic and Historical Factors in Violent and Nonviolent Offenders with psychotic disorders. Pacific University CommonKnowledge, 2-30.
