Diagnosis & Assessment
Axis 1: Clinical Syndrome: Dissociative Identity Disorder
Sherry has recently been given the diagnosis of dissociative identity disorder or formally known as multiple personality disorder. She has had multiple hospitalizations over the last several years, and has been given multiple different diagnoses ranging from schizophrenia (disorganized type), bipolar disorder, major depression, and borderline personality disorder. She has been placed on several different types of medications at the time of these hospitalizations depending on the diagnosis, ranging from lithium to a variety of antidepressant and antipsychotic drugs, such as Thorazine. Upon reviewing her case further I feel that the most probable diagnosis would be the one of dissociative identity disorder, she exhibits many of the key indicators of this disorder outlined in the DSM-IV-TR. Which is the presence of two or more identities, who take control over the persons behavior along with unexplainable periods of black out that can range from several hours to months of her life; these periods go beyond any ordinary type of forgetfulness. During one of her most recent hospitalizations Sherry became severely distressed and violent, demanding to know who has rearranged the hospital and the grounds, and kept asking to see people who did not exist, both other patients and staff members; she then became verbally and physically abusive towards the staff, shouting obscenities at them and swinging her firsts around as they made attempts to calm her. In the past, Sherry has made various attempts at suicide during these periods of black out, such as cutting her wrists and taking an overdose of tranquilizers, sometimes doing both. Sherry maintains a relationship with her mother and twin sister, she also was in a relationship for a period of time but they broke up after some time. For most of Sherry’s life growing up both her mother and father were physically abusive towards her and her sister. After her parents divorced and her mother remarried her stepfather also became physically abusive towards her and her sister. According to the DSM-IV-TR’s description of dissociative identity disorder I feel that her abusive childhood may be a contributing factor as to why Sherry developed this disorder. Although these attempts have ceased for the time being, and presently I feel that she is not a threat to herself or others I cannot confidently say that if another trauma occurs that she will remain as not being a threat to herself or others.
Axis 2: Personality Disorders or Mental Retardation:
At this present Sherry does not present any indications of a mental retardation or a personality disorder. Axis 3: General Medical Disorders:
Currently with the present state Sherry is in I feel that there isn’t any underlying medical conditions which she is suffering from, I would recommend a physical and getting blood work done just as a confirmation that there is no underlying medical conditions that we are not currently aware of. With her sexual history I would recommend getting a sexual health scan done just to be positive that she does not have any sort of sexually transmitted disease specially because of the fact that she had been raped before and also because the statements she has made before of having woken up in strangers bed after having unprotected sex with them. Although I am sure that she received testing done after she was brought to the hospital after she was raped I would recommend these tests just as a precaution. With Sherry’s history of self-mutilation and overdosing the blood work and other tests performed would be checking to make sure that her internal organs were not harmed during any of these suicide attempts and that she is in good physical health. Sherry has also suffered from anxiety for most of her life due to her painful and abusive childhood. Also I would need to review the previous medications Sherry was...