ADJUSTMENT DISORDER (EMPTY NEST SYNDROME) Short leave from work – traveling

40 YEAR OLD FEMALE CAME TO YOUR GP CLINIC Counseling- talking therapy - social worker, counselor,
COMPLAINING OF CHEST PAIN FOR ABOUT 3 MONTHS. ALL psychologist, psychiatrist
INVESTIGATIONS CAME BACK NORMAL. SHE STARTED TO OT – big army of supportive people
CRY AND INSISTS THAT IT IS HEART PROBLEM WHEN YOU Support group – community health center
EXPLAINED RESULTS TO HER. Local neigbourhood house
TASK: TAKE RELEVANT HISTORY Find gym and personal trainer
DIAGNOSIS AND MANAGEMENT
Suggest different activities as much as possible: walking
Red flag: Show Empathy swimming jogging, relaxation therapy, yoga, cycling
The role player will cry Last resort CBT (cognitive behavioural therapy)
Don’t be stressed. Let her cry – give her half a minute to
cry, give tissue or water

Gently touch shoulder

Start with symptoms

Your pain started 3 months ago, any stress in your life
before that?
Any change in your life?

Her daughter left (Son) 3 months ago

How often do you see or talk with your daughter

Do you live alone?

Do you have any supportive person? If yes, how close
are you to them?
Occupation? What do you do for living?
How do you cope with your job? Duties and
responsibilities at work?

Ask about appetite, sleep, sexual function, interest in life

Do you have any hobbies?

Suicidal Ideation?
Any ideas of harming the girlfriend?

You may ask a few questions about psychoses?

Do you hear voices
Delusion of guilt –

Management:
Your chest pain is real. All examinations are normal. But
most likely it is due to your emotional upset.
Adjustment Disorder (Empty Nest Syndrome) – a kind of
adjustment when child leaves the house the mom feels
alone and unsupported
Adjustment disorder – emotional or behavioral symptoms
in response to stressor within 3 months
Patient usually markedly distressed with significant
impairment in social or occupational functioning