How to diagnose a psychopathology of mental health case study (Solved)

How to diagnose a psychopathology of mental health case study (Solved)

Purpose: Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.
Jax is a 66-year-old Caucasian female whose wife has encouraged her to seek treatment. She has never been in therapy before, and has no history of depression or anxiety. However, her alcohol use has recently been getting in the way of her marriage, and interfering with her newly-retired life. She describes drinking increasing amounts over the last year, currently consuming approximately a six-pack of beer per day. She notes that this amount “doesn’t give me the same buzz as it used to.” She denies ever experiencing “the shakes” or any other withdrawal symptoms if she skips a day of drinking.

Jax comments that her wife is her biggest motivation to decrease her alcohol use. She tells Jax that she gets argumentative and irritable when she drinks, though she does not always remember these incidents. She has also fallen while intoxicated twice, causing bruises both times and hitting her head on one of the occasions.

Remember to answer these questions from your textbooks and NP guidelines. At all times, explain your answers.

1. Describe the presenting problems/issues. Is there any information that was not provided that you would need to formulate a diagnosis?
2. Generate a primary and differential diagnosis using the DSM5 and ICD 10 codes.
3. What physiological and psychological processes lead to substance dependence?


Case Study: Jax

The case study of Jax, a 66-year-old Caucasian female, presents problems associated with substance use disorder. Indulgence in alcoholism has led her to get away from her marriage and interference with her newly retired life. Jax describes drinking increasing amounts over the past year. She currently consumes approximately six –packs of beer every day. The symptoms include argumentative and irritability when she drinks; she does not remember such incidences when sober. History of intoxication and falls leading to sustaining injuries such as hitting her on one occasion indicate substance use disorder. All elaborated symptoms above show that Jax is a substance use disorder diagnosis. Additional information that would help form a diagnosis would include Jax’s history of alcohol use disorder, her family history of alcohol, and whether Jax had initially experienced withdrawal symptoms.

The primary diagnosis demonstrated by Jax in the case study would be mild alcohol use disorder. The differential diagnosis of the above case study would be depression, post-traumatic stress disorder (PTSD), and anxiety (Gowin et al., 2017). Depression and anxiety can contribute to Jax’s indulgence in alcohol use and hence can be considered a differential diagnosis. Suppose inclusion of a history of trauma and using alcohol use as self-medication PTSD would likely be the diagnosis.

Mild alcohol use disorder, according to DSM5 criteria, includes; engaging in drinking more alcohol for an extended time than intended, persistent efforts to cut off from the use of alcohol, having a strong desire or craving for alcohol, a recent history of alcohol consumption and marked lessened effect with unrelenting use of the same amount of alcohol. The ICD 10 code for mild alcohol use disorder would be F10.10, which indicates alcohol is taken to relieve or avoid withdrawal symptoms. However, the DSM5 criteria for acute intoxication include; recent use of alcohol and slurred speech. The ICD 10 code for alcohol intoxication would be F10.20. The DSM5 codes for acute intoxication include autonomic hyperactivity and cessation of alcohol use that has been heavy and prolonged. The case study of Jax’s symptoms is portrayed in the DSM 5 and justifies mild alcohol use disorder (Hasin et al., 2013).

Physiological dependence happens when the body becomes used to substance abuse and experiences withdrawal symptoms when the use of the substance is unavailable. Psychological support refers t when a person uses a substance to cope with life stressors. Physical dependency on a substance commences with the brain and works through the body. Physical dependence shows up when the substance is no longer present in the body. High levels of physical dependency lead a person into toxicity and shut down in overdose. The physiologic process of substance dependence begins at an early stage of substance use before addiction develops, leading to a hangover. Addiction sets in when the body expects a particular frequency and patterns. Once the substance is missed, cravings develop. However, the brain becomes reliant on the substance. They may not task well without it, which results in physical and mental withdrawal whenever the substance is tried to be limited.

The psychological process of dependence on substance use begins the same way mechanics of physiological dependence occurs; habitual use of the substance contributes to chemical dependency from the continued use of substance abuse. Chemicals altered in the brain leading to substance dependency include dopamine, serotonin, adrenaline, norepinephrine, ad endorphins. These chemicals possess a positive effect on a person’s body and mind. Continued use slows down the body systems to total shutdown (Waszkiewicz et al., 2018). Finally, continued substance use leads a person to develop mental illness.



Hasin, D. S., O’Brien, C. P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., … & Grant, B. F. (2013). DSM-5 criteria for substance use disorders: recommendations and rationale. American Journal of Psychiatry170(8), 834–851.

Gowin, J. L., Sloan, M. E., Stangl, B. L., Vatsalya, V., & Ramchandani, V. A. (2017). Vulnerability for alcohol use disorder and rate of alcohol consumption. American Journal of Psychiatry174(11), 1094-1101.

Waszkiewicz, N., Galińska-Skok, B., Nestsiarovich, A., Kułak-Bejda, A., Wilczyńska, K., Simonienko, K., & Konarzewska, B. (2018). Neurobiological effects of binge drinking help in its detection and differential diagnosis of alcohol dependence: disease markers2018.

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