Patient Clinical Assessment
The patient is a 25-years old White male, homosexual, currently single. He has a medical history of having a severe case of psoriasis and psoriatic arthritis, as well as clinical depression. He is currently being treated for depression by a certified psychiatrist; however, he does not receive any medical help for his psoriasis or arthritis. He has agreed to undergo the Adverse Consequences of Substance Use Tool and the Psychoactive Drug History Questionnaire under the pseudonym “Ram”.
Adverse Consequences of Substance Use Assessment
Ram stated that he did not experience any physical health problems related to drug use which was worth noting in the questionnaire. However, he mentioned that he had such issues in the past due to the excessive use of painkillers for joint pain that his psoriatic arthritis caused. As Ram himself reported, several rheumatologists reminded him that he should not overdose on pain medication to avoid having stomach and liver problems, and he conceded. He had not used large doses of painkillers in the past three years. It can be concluded that Ram does not have any physical consequences of substance use.
As Ram has been receiving various depression treatments for the past two years, he reports having several neurological effects related to it. He states that he often feels as if he cannot think properly or concentrate on tasks, and it is quite difficult for him to do his work. Moreover, he is constantly sleepy and has trouble waking up. From this, it can be concluded that antipsychotics and antidepressants Ram takes have affected his neurological functions greatly, to the point of periodical impairment. However, Ram reports that while he indeed experiences mood swings, they are not too extreme and do not affect his relationships or everyday life as a whole.
The patient admitted that he had several minor arguments with his mother regarding his treatment. According to Ram’s own words, he is quite close with his mother and tells her all about his depression treatment. However, he also states that she fears he is taking too much medication or that the drugs are “too strong” for him, also, she is worried about the fact he needs Quetiapine to sleep. Still, as Ram says, he almost always is able to calm his mother, and their arguments are not too strong, nor do they affect their close relationship. Moreover, he claims he did not become physically or verbally abusive due to his substance use – in fact, Ram says, the treatment helped him become more mentally stable and calm.
The situation with his inability to work properly due to substance use worries Ram a lot, as he himself states. He is almost always exhausted and often takes time off work as he does not feel he can concentrate on tasks. Despite his excessive sleeping, he wakes up unrested and, as he says, usually goes back to sleep after a few hours of being awake. However, Ram also admits that most of the time, he is able to pull himself together and work, as he needs money to live.
In regards to legal problems, Ram reports having none. He states he never experienced any troubles with the law in his life at all, and depression treatment did not change that. Finally, the patient admits that his treatment is rather costly for his budget. However, as he also says, it is not too extreme in regard to expenses, and he does not feel any strain due to his treatment.
Psychoactive Drug History Questionnaire
From the overall assessment results, it appears that Ram does not have any significant problems with psychoactive drugs. He reports drinking beer from time to time: for example, after a stressful day or to hang out in a bar with friends. However, as he stated, he never drinks more than one bottle. He admitted he had smoked weed twice in the last 12 months when he was visiting his friends in another country; still, it has been more than five months since the incidents of smoking. Ram claims he has never taken drugs, benzodiazepines, prescription opioids, codeine, glue, or hallucinogens. He admits that he smokes cigarettes daily; the habit has persisted despite his efforts to quit in the last 6 months. Finally, he takes depression treatment in the form of Quetiapine, Mirtazapine, and Sertraline: all drugs were discharged by a certified psychiatrist, and Ram claims he follows the dosage strictly.
Possible Interventions
Ram could be advised to try to quit smoking again, as this habit is not good for his health, especially due to his psoriasis. Overall, he appears to not have any significant issues with substance use; however, the depression treatment he takes has some negative effects on Ram. Perhaps it would be good for Ram to take time off work to properly rest without stressing out about his ill performance. Moreover, he should discuss the effects of the medication with his psychiatrist and see if the doses could be reduced or if the medication could be changed.
What Did I Learn
This assignment helped me understand a lot about the effects of substance use. It was an interesting experience, and I now can see more clearly how depression treatment might affect a person in many different ways. Ram was a great subject to assess – he answered the questions honestly and willingly and elaborated on his answers where it was needed. He was quite comfortable with undergoing the assessment, as he himself stated that his psychiatrist often performed various tests on him. He was friendly and open the whole time, thus, I also was very comfortable with questioning him and was able to use the assessment skills to the fullest.