How to write a DSM5 Diagnosis based on a case study

How to write a DSM5 Diagnosis based on a case study

Case prompt: Chapter 11, Case 1
Lotus is a 36-year-old Asian American female who recently started a new executive position with an advertising firm. While she loves her new job and the field of advertising, she admits that the new schedule is grueling and that she often doesn’t get home until quite late. She has noticed that it is difficult for her to relax before getting to bed and her mind often wanders to the many tasks she needs to complete when she returns to work in the morning. These “racing thoughts” result in significant initial insomnia, causing her to be alert for nearly an hour or more before she is able to fall asleep. When questioned about these symptoms, she claims that she has never seen a therapist before, doesn’t consider herself to be anxious or depressed, and has never had a problem with sleeping in the past. There are no worries of money or health-related issues, and she claims to enjoy her job and the people with whom she works. She even does not find these thoughts unpleasant, as she uses the time to plan her next day. She admits that they are just a bit intrusive and that she really needs to wind down and get more rest.
1. Summarize the clinical case.
2. What is the DSM5 diagnosis? Identify the rationale for your diagnosis using the DSM5 diagnostic criteria.
3. According to the clinical guidelines, which one pharmacological treatment is most appropriate to prescribe? Include the medication name, dose, frequency and rationale for this treatment.
4. According to the clinical guidelines, which one non-pharmacological treatment would you prescribe? (exclude psychotherapy modalities) Include the risk and benefits of the chosen rationale for this treatment.
5. Include an assessment of medication\’s appropriateness, cost, effectiveness, safety, and potential for patient adherence.
6. Use a local pharmacy (Pensacola, FL) to research the cost of the medication. Use great detail when answering questions 3-5.


Summary Of the Clinical Case

Lotus is frequently awake at night since she doesn’t get enough sleep. These may be related to her new job, causing her a great deal of anxiety. It is typical to experience nervousness before starting a new job. As a result of having so much on one’s mind, these concerns are the main cause of insomnia. She may not be accustomed to the new schedule; therefore, it takes time for her to become acclimated to it. Many people experience it, which can take several weeks or months. However, seeking a therapist for support is advisable if sleep deprivation persists.

DSM5 Diagnosis.

Generalized anxiety disorder

Rationale For Your Diagnosis Using the DSM5 Diagnostic Criteria

Generalized anxiety disorder is characterized by extreme worry and anxiety about several occasions or activities on most days for at least six months. It is challenging to control the concern, accompanied by bodily symptoms like tense muscles, impatience, trouble sleeping, and restlessness. The anxiety is not restricted to symptoms of a mood or psychiatric problem, is not brought on by substance abuse or a general health issue, and is not exacerbated by these conditions (DeMartini et al.). An individual’s ability to manage anxiety is compromised, and it causes impairment in key areas of their lives. Lotus presents with excessive ongoing worry due to her new executive position and the gruesome schedule that makes her work late into the night. Also, she is restless, with racing thoughts that are proving difficult for her to control and difficulties falling asleep, thus pointing to generalized anxiety disorder as per the DSM 5 diagnostic criteria.

Appropriate Pharmacological Treatment to Prescribe. Include The Medication Name, Dose, Frequency, And Rationale For This Treatment.

Alprazolam 0.25mg thrice a day for a period ranging from 1 -4 weeks, depending on the symptoms. The doses can be tapered. This medication is classified as a Benzodiazepine. The medications are beneficial because they can be prescribed whenever they are needed, for instance, when the patient is particularly anxious (DeMartini et al.). In addition, the medications have a quick onset of action, and tolerance rarely develops.

Non-Pharmacological Treatment Would You Prescribe? Include The Risk And Benefits Of The Chosen Rationale For This Treatment.

CBT is an evidence-based insomnia treatment that is typically delivered in weekly sessions lasting 60 to 90 minutes. The patient and the therapist collaborate closely during this time to pinpoint the causal factors of the anxiety (Nordahl et al.). Once the problem has been identified, the patient is helped to come up with fresh, constructive ideas and habits. CBT comprises sleep instruction, relaxation practice, and sensory control therapy. All the methods mentioned above assist the patient in calming their thoughts, which lowers sleeplessness. Also, relaxation exercises, for instance, yoga, healthy eating habits, and sleep hygiene, can be recommended to the patient.

 Assessment of medication\’s appropriateness, cost, effectiveness, safety, and potential for patient adherence.

We determine that CBT is the best course of action for Lotus’s sleeplessness. It is among the best techniques for recognizing unfavorable ideas. It is often given in 6 to 8 weeks sessions and costs $50 to $100 each (Psychology Today). CBT is non-invasive and has minimal disadvantages making sure the patient adheres to the procedure and the principles. Alprazolam 0.25mg to 1mg cost ranges at  $3 to $5 per tablet. The insurance can be used to cover the purchase of medications.


DeMartini, Jeremy, et al. “Generalized Anxiety Disorder.” Annals of Internal Medicine, vol. 170, no. 7, 2 Apr. 2019, p. ITC49, 10.7326/aitc201904020.

Nordahl, Hans M., et al. “Metacognitive Therapy versus Cognitive–Behavioural Therapy in Adults with Generalised Anxiety Disorder.” BJPsych Open, vol. 4, no. 5, Sept. 2018, pp. 393–400, 10.1192/bjo.2018.54.

Psychology Today. “Find the Best Therapists and Psychologists in Pensacola, FL – Psychology Today.”, 2022, Accessed 30 Oct. 2022.

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