CHAPTER VII

DIAGNOSIS

This chapter discusses the five axes included in the DSM IV TR. A multiaxial system

involves the evaluation of several axes, each of which relates to a distinct category of

information that may benefit the physician in treatment planning and result prediction.

Axis Clinical Syndrome

I
DIAGNOSTIC CODE DSM - V NAME
295.90 (F20.9) Schizophrenia
Prior to admission and treatment, the patient experienced behavioral changes
when patient failed to take the CPA board exams that resulted in being irritable,
easily-angered and delusions.

Axis Personality Disorder, Mental Retardation and Defense Mechanism

II
DIAGNOSTIC CODE DSM -V NAME
301.81 (F60.81) Narcissistic Personality Disorder
297.1 (F22) Delusional Disorder
Denial
Suppression
Projection
Due to traumatic emotional life events, patient developed grandeur and
persecutory delusions. As the patient was having mental changes, she also
developed narcissistic and delusional personality disorder where she exhibited
emotional flat, numb emotions and sharp stair; odd beliefs such as believing
that she is a certified public accountant, and that she is employed freelance; odd
thinking and speech like having irrelevant phrases constantly inserted into her
responses “its comes from within, not from without.”

Patient’s coping mechanisms are denial as the patient denies the reality of her
situation causing her to delay medical treatment. Moreover, she also has
 delusional personality disorder as she often refers to herself as a CPA even
when she is not. She also believes that as a part of being a CPA, people are after
her most of the time.

Another coping mechanism of the patient is suppression since she excludes her
personal feeling from her trauma and projection the patient manifested
projection through blaming his father about her father inability to take the board
exam. Patient conjured ill memories about her father physically abusing her,
which was denied by the informant.
Axis General Medical Condition
III

No medical condition has been diagnosed to the patient.

DIAGNOSTIC CODE DSM - V NAME

None None

None

Axis Global Assessment of Functioning

V
Score 40-31 Time frame: 26 years
GAF Scale Code 40: Patient displays some impairment in reality testing or
communication with obscure or illogical perception of events. Patient has major
impairment in several areas such as work, thinking, such as tangentiality and
her blunted affect.
Diagnosis: Schizophrenia