Diagnostic Case Study

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Diagnoses considered:
ADHD – had been previously diagnosed
Bipolar Disorder
Bipolar II Disorder
Intermittent Explosive Disorder
Major Depressive Disorder
Schizoaffective disorder

Consideration of the above referenced diagnoses were based upon the following characteristics: •Endearing behaviors at times.
Exceptionally bright (per his teachers)
Excessive length of outbursts- longer than 30 minutes
Over activity and impulsivity
Lack of attention for dangerous situations and actions.
Perception that nothing can hurt him (grandiose perceptions) •Classmates avoid him (find him overwhelming)
Uncontrolled mood swings
Previous diagnosis of ADHD (medicated)
Behaviors/ moods worsening over past four months (more severe and prolonged) •Doesn’t hear during his tantrums nor does he remember incidents following the tantrum. •Violent, destructive, self injurious behaviors during tantrums •Following the tantrum he is remorseful and seeks reassurance •Moods are random and unpredictable

Verbalizing suicidal thoughts during tantrum.
Difficulty sleeping and doesn’t require much sleep
Gross and gory nightmares
Imaginary figures appearing to him multiple times daily instructing him to do “bad things”. •Mother suffers from depression.
Father’s aunt had bipolar disorder and committed suicide by 30 •Not welcome in the homes of neighborhood children.
Claimed to have MANY friends, but mom stated he had none •Ambivalent response to medication effectiveness by parents

Diagnosis selected:
Bipolar II Disorder (Recurrent Major Depressive Episodes with Hypo manic Episodes) •Retain diagnosis for ADHD

Axis I:
314.01 Attention Deficit Hyperactivity Disorder 296.89 Bipolar II Disorder

Code numberAxis I Diagnosis Selected

Justification for the Diagnosis:

Daniel met the following criteria for Bipolar II Disorder:
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