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ALZHEIMER'S DISEASE.
Term Paper ID:30543
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Essay Subject:
Discussion of the DSM IV diagnosis of the disease.... More...
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4 Pages / 900 Words
4 sources, 5 Citations,
APA Format
$16.00
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Paper Abstract:
Discussion of the DSM IV diagnosis of the disease. Information needed to complete the five axis diagnosis. Uses a fictional client as an example of how to form an accurate diagnosis. Criteria needed including memory impairment, cognitive impairments, gradual onset, elimination of other conditions that could this this specific dementia. Intervention plan.
Paper Introduction:
DSM IV DIAGNOSIS: ALZHEIMER'S DISEASE
DSM IV Criteria
Axis I 290.10 Dementia of the Alzheimer's Type, With
Early Onset, Uncomplicated
Axis II V71.09 No diagnosis
Axis III Alzheimer's disease
Axis IV None
Axis V GAF = 31 (current)
The above five axis diagnosis is preliminary only since some of the necessary information is unavailable at this time. Axis I, Dementia of the Alzheimer's Type, is substantiated by the following criteria: (A) memory impairment, failure to identify objects (agnosia), and disturbance in executive functioning; (B) the cognitive impairments cause significant impairment in
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Alzheimer's Disease and depression.Journal of Counseling and Clinical Psychology, 6 (3), 379-391. A. Counseling fordepression is therefore recommended despite the client's claim to be happyand coping. Additionally, current research states that agents calledcholinesterase inhibitors, enhance and preserve cognitive and behavioralstatus of the AD patient (Rivas-Vazquez, 2 1). (2 1). Cholinesterase inhibitors currentpharmacological treatments for Alzheimer's Disease. Theclient reported that he has a wallet card, identity necklace, and isregistered in a program that provides a national registration and a 24-hournumber for assistance. Rivas-Vazquez, R. It is only assumed to be early onset at this time since hewas working as an electrical engineer when symptoms began. Axis II has no diagnosis since there is no mention of any personalitydisorder or tendencies. Sincehe maintains an optimistic outlook and an overall interest in seekingpositive situations, these recommendations are considered practical. Although medicalreports would be needed to confirm this diagnosis, it is implied by theclient's referral to himself as suffering from AD. ). (1992). 9 No diagnosis Axis III Alzheimer's disease Axis IV None Axis V GAF = 31 (current) The above five axis diagnosis is preliminary only since some of thenecessary information is unavailable at this time. He stated that he has "done it all" and"enjoyed it" and had "the love of some beautiful people." Biological,Psychological, and Social Intervention Needs The client appears to be coping with his disease and decliningabilities. The client reports that his memoryloss and mental abilities were suffering from a gradual decline, withincreased confusion and inability to function cognitively. (1994). He is enrolled in "Safe Return" and currently participating ina drug study. Examplesincluded mistakes writing checks, inability to remember friends' faces andnames, lost details, inability to function (unable to fill out forms,couldn't remember what instant coffee was, can't find right words for aconversation, lost). Since his current functioning is very low and support fordepression has been shown to increase these behaviors, it is worthconsidering. It is possible that additionaldrugs would help alleviate some of his symptoms and psychologicalcounseling may relieve symptoms of depression, which may be unknowinglyexacerbating his overall state. ProfessionalPsychology: research and Practice, 32(4), 433-436. References Alzheimer's Organization. Washington,DC: APA. Since presentations meetingfull symptom criteria for a Major Depressive Episode, which are requiredfor this diagnosis, are not present, Axis I is Uncomplicated (APA). Thisinformation was not given and the final diagnosis requires age of onsetinformation. Although he indicated that he is able tocope with his feelings and is supported by Stella, he also stated that attimes he felt he was the only person in the world with this disease.Additional psychological, social, and medical intervention is recommended.Intervention Plan A multi-faceted and practical approach to intervening with thispatient would include recommending that he do more than join "Safe Return,"and begin participation, with his family, in educational programs, supportgroups and social activities offered by a local chapter of the nationwideAlzheimer's Association. For example, increased frequency andduration of pleasant activities has resulted in significant decreases indepression and other AD behaviors (Teri & Wagner, 1992). Therefore regular doctorvisits are also recommended with education regarding additional drugs, andthe possibility of trying a new drug if the current one is unsatisfactory. Drugs such as tacrine have been found toalleviate some cognitive symptoms, and other drugs help with sleeplessness,agitation, wandering, anxiety, and depression (Alzheimer's Organization,2 1). Teri, L., & Wagner, A. However, he also states that his abilities have declined toa point where he withdraws from activity. Although the client does not present a symptomconstellation that meets criteria for a Major Depressive Disorderdiagnosis, studies have shown that behavior therapy and supportiveintervention can assist AD patients. Diagnostic andstatistical manual of mental disorders, fourth edition, DSM-IV. (2 1). Axis I, Dementia of theAlzheimer's Type, is substantiated by the following criteria: (A) memoryimpairment, failure to identify objects (agnosia), and disturbance inexecutive functioning; (B) the cognitive impairments cause significantimpairment in social or occupational functioning and a decline fromprevious functioning; (C) course is gradual onset and continuing cognitivedecline; (D) cognitive deficits are not due to other central nervoussystem, systemic, or substance-induced conditions; (E) deficits do notoccur only during delirium; (F) disturbance is not better accounted for byother Axis I disorders (APA, 1994). In thiscase there is no indication of delirium or delusions, but the clientpointed out that he felt very sad and anxious and began to withdraw fromothers. Although the client tends to avoid group activities, thisappears to be due to his decreased abilities and self-consciousness. Treatment of depression as a separate disorder needs to be consideredwith the AD patient. Client Information, Needs, and Intervention PlanStrengths, Assets, Social Context The client presents the strength of being able to remain positive andfeel loved despite his declining mental abilities and emotional reactionsto the loss. He stated "I have a sadness and an anxiety that I have neverexperienced before." However, he also stated that he felt and remainedpositive with feelings of support from Stella. Axis I also lists whether or not symptoms are Early Onset (at age 65years or below) or Late Onset (after age 65 years; 29 . Axis III is Alzheimer's Disease. He reports that he feels supported by Stella. He reported that at times he is disorientated,confused with speech garbled, and gravely impaired. Axis IV is none sincethere is no mention of additional psychosocial and environmental problems. DSM IV DIAGNOSIS: ALZHEIMER'S DISEASE DSM IV Criteria Axis I 29 .1 Dementia of the Alzheimer's Type, With Early Onset, Uncomplicated Axis II V71. Axis I alsostates the presence of Delirium, Delusions, or Depressed Mood. Although hefound himself withdrawing from others, he remained feeling treated byStella with "love and respect." He also felt an anger and rage, butrefused to carry around the anger. Alzheimer's Disease fact sheet.Found online at: www.alzheimers.org/pubs/adfact.html American Psychiatric Association (APA). Axis V is 31 since it appears that the current functioning is beyondserious symptoms and impairment to include some impairment in communicationand judgement to the point of being unable to function at times.
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