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  • Topic: Anxiety, Obsessive–compulsive disorder, Compulsive behavior
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  • Published : April 4, 2013
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DIAGNOSTIC EVALUATION REPORT

PATIENT: Melvin UdallDATE OF BIRTH: April 29, 1941
135 West 12th Street Apt. 10
Manhattan, New York 10019AGE: 56

EDUCATIONAL LEVEL: Master’s College GraduateMARITAL STATUS: Single

DATE OF TESTING: June 17, 1997REPORT DATE: December 20, 1997

EVALUATOR: Jeremy WilsonREFERRED BY: Dr. Robert Green

REASON FOR REFERRAL

Reexamination was requested by the patient, Melvin Udall, on June 10, 1997 to determine his psychological dynamics and functioning, and confirm the previous diagnosis of Obsessive-Compulsive Disorder. Melvin was first diagnosed in his early to mid-twenties and the effects have been dynamic on his personal, social, and professional life. The psychiatric and psychological reevaluation was requested by Melvin to decrease his obsessions and compulsions. He also requested assistance for irritable and aggressive behaviors attributed to his narcissism. The disorder was affecting almost all aspects of his life. Melvin’s romantic relationship with Carol Connelly was indicated as the motivation for treatment. He was concerned that his newly found happiness might be compromised by his obsessions, compulsions, and deficient social and emotional skills. Melvin Udall “wants to be a better man” for Carol and is worried that without confronting his anxieties and social awkwardness that had taken control of his life, he will end up a lonely and sad old man.

PROCEDURES ADMINISTERED

Clinical Interview
Mini Mental Status Examination
Yale-Brown Obsessive Compulsive Scale
Modified Global Assessment of Functioning Scale

BEHAVIORAL OBSERVATIONS

Melvin Udall was cooperative and developed a friendly rapport with the psychiatric and psychological evaluators during testing. Melvin’s affect was normal throughout the interview. He was dressed appropriately for the evaluation. His concentration was focused intently on topics of personal concern and at times his obsessions and compulsions were difficult to manage. Melvin’s speech was normal and direct, of normal modulation and tone, and no unusual speech difficulties were noted. Posture and gate were about average for a man his age. Melvin was alert and oriented to person, place, and time. Melvin’s intellectual functioning appeared to be significantly above normal; however, his social functioning appeared to be below normal. Neurological difficulties were not present during the course of testing. Melvin displayed phenomenal attention to specific details of interest throughout the interview. He was prone to respond unsympathetically to social cues, struggling to recognize that his cruel use of words can be extremely painful to others. In general, however, the diagnosis of Obsessive-Compulsive Disorder appears to be an accurate reflection of Melvin Udall’s present functioning.

BACKGROUND INFORMATION

Melvin Udall is a 56 year-old white male who entered Mount Sinai Obsessive-Compulsive Disorder Treatment Center because his obsession with germs, compulsive microbe prevention, and narcissistic behaviors were threatening to ruin his life. The onset of his disorder was gradual and did not start to interfere with his life until he was 24-years old and writing his first book. He had recently started romancing an attractive, down to earth woman, but feared losing her because his repetitive compulsions of cleanliness and narcissistic attitude arose frequently in her presence. The powerful and strange obsessive thoughts were difficult to overcome and at times were paralyzing. Melvin reported many compulsive behaviors including excessive hand washing, glove wearing, use of plastic utensils, and locking doors and turning lights on multiple times. He explained that he becomes anxious when others enter his “bubble” or touch him. Evidence of his obsessions and compulsions were apparent by the blistered skin and bloody knuckles on his hands. He explained that the compulsive behaviors...
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