DSM-IV-TR CASEBOOK ‘A Learning Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision EE Edited by Robert L. Spitzer, MD. Miriam Gibbon, MS.W. Andrew E. Skodol, M.D. Janet B, W. Williams, DS.W. Michael B. First, M.D. Columbia University and the New York State Psychiatric Institute Zooz.70 DSMLIV-TR CASEBOOK. it wot ecogrize hat what he peeved as “uns” Ba was ac Sty popular Caribbean ail. Had nt been for Mr. Sowers frattcing presen, he decor gh have ewe im a Ma Thane rather than as wid an organized, He might ao have toned that hs speech was presse, he 8as no seeping el Ne ‘Man iable and hypenexcal—all pions suggesting 4 posse Tanke Episode CDSMEIVTR, p, 362, The subsequent ou, which Mr Siver demonstrated grapaosy and an expansive mood, fa ther suppons tis diagnos In the abence of ay Information Shout prior Manic or Nbjor Depesive Episodes, the diagnosis ould be Bipolar 1 Doors, Single Manic Episode, Severe WH Pela Festres (DSA AN-T, p38. Sts hve demonstrated sr nics often mindignone AE rican American paint as having Schizophrenia rates than Bipo- Tor Doone this case the premnary suspicion of Schizophrenia ‘ofa subsunce inoncaton was reaseabl, butte dere ‘agoie hould have ineided Bipolar 1 Disorder Weh Papehotic CERTIFIED PUBLIC ACCOUNTANT Maurice Rosen was 8) when he made an appoionment fora neurokogical vation. He had cent hat as memory was ppg a fad problems with concentaon that were Doping interfere wt is roves asefemployed ax acount. He complained of slowness and Taig his ain of thought Recent changes nthe x laws were fad For ‘nto exn dis wie sid was becoming more wiiawn and ican ttn activites However he was sil able to ake care of is ‘pononal ances and accompany his wife on vss o fends bout hily depressed about his diabies, he denied ther symptoms of “epremsn, such as tube seep x appt, feelings fm oF uc teeston, ir Rose has Jong history of treatment for episodes of depres poping in hi 2. He hs taken «numberof deren anes n 0 years ago he developed an itera resting tremor ibis eft anda shuling gst Alough the digo of Parkinson's disease considered by his psychatrt, tas ot conned bya neroog, therefore no atonal ueament was gen, The neurolopi who was now evating hn found ha i pont speech washes and unclear (site). Canal nerve ea on Was nom. Motor one ws ncessed ily nthe neck a all hs lterating movement of his hands were performed lowly. He a ight ireritent emo f the left ara est Reflexes were A diagnos of pac Parkinson's daca was de, de placed on low done of eafidopa, + mevicton that alleviates the coms of Parkinson's dese “A newopsychologcal examination perform hice weeks Ir r= average performance onthe Wether Ad Ieligence Sle — all scale 1Q= 108, but vet 1Q of 118 nea performance Df A. Memory a sees by 12m, Ori, elect ending wat poor with no more than 7 Res recalled on any tal and ony ch eal afer a Senne dey tng he pate cok ecgrse ing words, He howe marked ify eng of one es sd pra es He was unable ode hee denon In language tetng he demoted pred ring In san- fy Nc. Hosen diplyed evidence of paket in mexnory, naming, ruil abies. Theve may have been. sco to kw {poor planing, nd perseveration The defies were eve to 6 Imaging ssn, whch revealed only generale atopy, td encephalogram, which was significant fr background genet 1 the ft reurologée who saw Me Rosen net make of Parkins dea, these develope an err a et ancl abaomlies in sce ander te fied the dagneicThe secon neoogkl evapaldircted aciviies On nawopsychologial exami MF owen showed impart in memory, raring, and constuction ‘bine Adee toms when ey ar sense 0 zane panera functor nda the presence Cue significa fa dome Tus the digs Dementia Due to Packnso's ‘Diocne Without Behavioral Dicsbace (DSMLTR, p16. Nt pets wth Parkinsons ease eventual develop some ‘cogntve manent the onset ofthe Parksnson's ease is te soli orate history of depression (hth of whieh were tue Irth cso the Gereopment of deren is more ely Follow-Up AWANDERING MIND [Nose Hamiton,» 35-year ek and mothe of es salen, pple or etncntatMontara rca eat clinic wih he corpsint teeesiy mun! wander shard for ne keep ey atetion on one ask wt dnracted 3 eas” She ako describe here as cso ‘aloe tae an ad tempered She eve to overeat emoxionaly Tru wrceiten epee for dasa ine. Hee eatonship with er long inc over bepus to une The couple id frequent arguments, ex nal Disorders in Adults shat by Newent He ow solve she ao ound iil “the dese as “hypercve” ‘The payliast aske the patent Slr in which she wan asks 99 ec tess place Nore a the th pa “Athoug eren's mero of he eel Deing a dscipnary problem ‘ls office in eemetary seo She I Shee 20 and sgain a age 23 saw Cv oping” er mariage, which hid he bith of ert, ge 29 est Finally, 2 year apo she weth lini apd was gen anew fal moms wahout ay nie Discussion of “A Wandering ‘The longer symptoms of a il sonal relationship ad chy be dagnass of Borderie Personal es aot have any othe othe ch er such sient prem te Suid chavo, chun felis {sprobebiy the core: dag ‘anders. hard Foe me to ke fe disracted so eal This proile {Sone of the cardinal symp of Disorder au her mother conti th porta, the other tuners fe ‘Curren Norse asthe ll eit ica antag tenn tract, We anime hata hh tems, such a fig 10 ater fd inrrctions, Because she fe 6 ot the ful synione ass wy th sts ino acho, the dagen ‘Daosder,In Fara Remission (DSHsods but when i elaborated to cet the * Int dager then abou! be Seed ns own dha the Vede Malngesing (DSMEIVTR, p73 CLOSE To THE BONE A 23 year od woman fom Arkansas ‘ork esearch group afer seing 2 teeson program in ese her pales as fll: sever you agen lege # te ing iates 1 se weih SERS Tans tow and inten the amber they Becme ficc SRETSatrZ gen tae hig 2-20 eka ills at oe ie wah & aoe arm per elp Twin ne as ch as 20 pounds 8 a Bt pene may wae ade fed, and well bel dye ‘cds poe eu tad cou bref Fede ine orca ney seen ies nh ages fos poser, vert ee ih ks tse tens, C8 TEES hn uy nwo. Asal ode eer appeed nde Srpcreon ens 5 Te ntcatordaya th woken someting.and nec dating sn unr wal exec Ren de oe ie arse ceo fred heel co 0 dat she woud sae el very eve wae acer et could aan ee ia anc fd iit and sil xe weg. THs WS Spagna 5 pounds ve ew mons. 1 pounds Peat coming at in anu andy toch Wor oe ence on mae cone tou ty appear: nse ce namin ote bone sate AHL ae ater | nge, when {woud be lows aed dade. heer extrband tek vena wun, fer vm Teeny nomoch was ence tre at py The mie Hx em spas at feign Tress we al pound ote a i dik wae fr dys ie take moe. Ye From Spr Rl hada A, Gm M, ea: Pct Gas Bok ewan crow 1988 syrote enero tbe head af a New ‘otic he de wethe hs work nh potent wth uous eating ates, I the ete, “Stic requewed Hat she be acepled ino his progam the woman d= lean ccnp Ingew tinge aban leony eine cane ‘oust wens ee am at dg tein thy ys te cli a Yap Gay orbit ood qe gp ou mate nda, nth Cone nny come end iege sme ping yin tot bes eng cat et Be mtn etic vere gre ety oo iooncm chon ity rags wm ce pope Th theeminaedin 2 ear le oad ee iy fro aed tsa meen a pay cs pe oc aorthustoval fank-sacag- senting med Me ed ‘ebb eins Ina coll ny Fan aad mpl tenia verance ISHS punts have wove ‘renee atan det wh fone ote ay mca ‘pets font wink ped anon Inds Ieee yo spar ey syn tegrated eon (ec fy et Ts rm tote pele stack sd dope oes cachscnctr cing eye rg ea ee cs Tasyed wth Te ty ymca een et te dors ny a cme wn Tage ptr comepoae cs ‘he ng oni wo Becks am de cmon nosy al Feecanpan ct wn oy beste pl wa att esr enh beet " at rao sand Taf ones nore eget hn soy what an deg ope pnafew poset hae tee te bre at pple Vt sd ebm be Dose ie te en attics le oer ath at ‘nc aad nye ‘eraerachg tune yk joe wtf scone nonin aa bce the dae tl exp met apne gt eh fetccnopreme Rrticnmeponl ascend emt Scoot phe lhe ow‘he mura up escola ok ate sont ane ecto ee ren ec ORE ani ee ond ve en ae eee pero by ah donee petselan ene MY Ceri eoae iors Tess ei Socriceoaly Spammer Ge De Nae ens acne Bor bingy a null Seed aod my tte trees Uy ester oes to pect neta. ene pc cml tn rene ocr nie sniivallt mate stefan ni nie a mom yc cota a btn re akirgse ash pny Tsay wt epi es aed ‘ilies aim ee ae ej Ty say ein cit eirmod oda Eon sera Apap abet roniy me vo eg No avi nny abot Ne beng moet Sens asap tengo ap smd Somes ‘cy nt aie iene ry Ate hamster eet a em be pesgagint cach ah ned Sit hutactn ecessofeat a ofe er rat ates aig toa wich my we etcetera wee pon ape a terial rn roronds steph sae ar ice te we nd he cee peste wach mes oman sa ctnstoseparthe ‘ce amsdambugtnsty we md sudan et wot sundae Man eee tat any ke sal pany re Sey sack Nodes, oy me Set oes any tee Disa 125 pounds ae ha eiched Ne dt high of 5 fc, 6 nc ery aan ean to clit witout gest sucess. At age ele 165 pou ar began to diet more serous for feu that “woul be nnled and went down to 13 pounds oer the nex he rciled feeling vary depres, overwhelmed aa hse She bepan to avoid dict capes so that she would ever tes aight A's and began wo We about her school and grade pio. for ear of being numilated. She ha great social ary in des boys, which culminates her waning to i schol or year of high sco ‘When si eft for calege, her dubs iperesed, She hdl ouble how 1o ganze her time—whethe osu to date, eto 506 She came more desperate to lose Weigh begn tse kn a8 she descbos in her leer. A ge 20, in he scphanone ea of she reached her lowest sight cf #8 fs 0% of Weal boxy i} and Xopped mensruating, IMs aval descbes i he eter, she rece that thre was a and every ferod hereto gain weigh. Nonethelem the and voriting she ad bagun the previ yar worn As she pe wth her weg an! her eat be schoo pean hand she doped out school aay thou collet a 2. Duval ste second of four eiren athe only gi. She comes fn upper midce- wi age stbem and ot es ings be eee nk inh coy of th Orr ‘tee arene estos ave cores wih a poo gs rn acm oe rope aan RBIS puts dees be pone eens ines he ao ea ence bh sd and Me eset al pete sos 10s Wa si tas pemorta evl f unioing te see Agen be Pees Derr DSVV-R p30 ae peal tase ode hs moe tan | oh TRE MIE'S cout awe ne who ol rt a ee ama to Sano Doar OUT a hace they fans as win wea a ecuatic change hal behav or oi utopia ations foe eps Mee waaay in God Ponte Fae Other Cases From Africa ‘THE ELEVENTH PREGNANCY Uisaue heat sae Nici ime nO Se a sree ae Airsigcss. These ymgxons