Nicolas, 27 years old, is a Hispanic male who reports three years of anxiety attacks. Thus, the complete diagnosis is F41.1 Generalized Anxiety Disorder, and this issue does not imply any specifiers or severity measures. However, it is possible to highlight additional conditions that can deserve clinical attention. It refers to Z codes, including Z60.3 Acculturation Difficulty and Z60.0 Phase of Life Problem because of Nicolas’s occupation.
A few specific symptoms demonstrate that the proposed diagnosis refers to Nicolas. The patient creports that he feels on edge since high school. Other complaints include difficulties focusing, sleep issues, and physical symptoms such as bloating and nausea. According to DSM-5, these four symptoms are sufficient to claim that Nicolas has a Generalized Anxiety Disorder. Shortness of breath and sweating also indicate that the proposed diagnosis can be applied to the patient.
A few differential diagnoses were considered before mentioning a Generalized Anxiety Disorder. Firstly, a Social Anxiety Disorder could also result in Nicolas’s problems, but this condition was eliminated because there were no signs that the client only experienced symptoms when speaking, writing, or performing in public (Morrison, 2014). Secondly, Anxiety due to Another Medical Condition does not refer to Nicolas because the patient’s physical health is not the primary source of concern.
Various instruments exist to assess the client and validate the diagnosis. For Nicolas, it is reasonable to use Hamilton Anxiety Rating Scale (Sudhir et al., 2017). This instrument is appropriate for adults with anxiety symptoms, and clinicians should complete 14 statements about Nicolas to identify the client’s condition. This approach is relevant because it implies that a professional social worker performs evaluation, which reduces the bias that exists when clients deal with self-assessment.
Finally, Nicolas needs a specific intervention to address the symptoms and mitigate their effect. According to Sudhir et al. (2017), the combination of metacognitive strategies and cognitive behavioral therapy is a suitable choice. The rationale behind this statement is that metacognitive strategies can help the client understand that it is not necessary to worry about aspects that are beyond his control. Simultaneously, cognitive behavioral therapy promotes relaxation and coping skills training to allow Nicolas to understand what he should do to mitigate a Generalized Anxiety Disorder.
References
Morrison, J. (2014). Diagnosis made easier: Principles and techniques for mental health clinicians (2nd ed.). Guilford Press.
Sudhir, P. M., Rukmini, S., & Sharma, M. P. (2017). Combining metacognitive strategies with traditional cognitive behavior therapy in Generalized Anxiety Disorder: A case illustration. Indian Journal of Psychological Medicine, 39(2), 152-156.