discussion 6

Fiona is a 29-year-old woman who works in a medical factory making medical equipment. She lives with her husband and in-laws. Over the last week, she has been more isolative, saying strange things to her husband, and not sleeping due to unidentified fearfulness. The only stressor that her husband can identify is that they started talking about having children. Fiona refuses to do her ADLs, eats very little, and appears intermittently in a trancelike state. The family was becoming more and more concerned and attempted to get Fiona to see their family doctor, but she was refusing. Finally, police were called due to worsening regressed behavior and Fiona was brought to the local emergency department (ED) for evaluation. The ED physician examined her and reported after labs and neuroimaging that she was medically stable. Although the patient reported no history of psychiatric illness, she did report that her maternal grandmother was in a state hospital for most of her life. The physician recommended psychiatric hospitalization for new onset of a psychotic illness.

1. Summarize the clinical case.
2. What is the DSM5 diagnosis?  Identify the rationale for your diagnosis using the DSM5 diagnostic criteria.
3. According to the clinical guidelines, which one pharmacological treatment is most appropriate to prescribe? Include the medication name, dose, frequency and rationale for this treatment.
4. According to the clinical guidelines, which one non-pharmacological treatment would you prescribe? (exclude psychotherapy modalities)  Include the risk and benefits of the chosen rationale for this treatment.
5. Include an assessment of medication’s appropriateness, cost, effectiveness, safety, and potential for patient adherence.
6. Use a local pharmacy to research the cost of the medication. Use great detail when answering questions 3-5.

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