Assignment

11/22/2025 This case study is on a 24-year-old Asian American graduate student who presented with anxiety, sleep difficulty, academic stress, and finger-biting leading to scarring. The symptoms of the individual have been deteriorating with the onset of anxiety since the last two months of beginning graduate school. Using evidence-based assessment techniques and referring to the DSM-5-TR criteria, the study gives identifies relevant screening tools, generates a list of possible diagnoses, chooses a workable diagnoses and treatment suggestions. These suggestions are treatments medication therapy etc. Also, it discusses the ethical and cultural dimensions, and it will be necessary to educate the patient. (American Psychiatric Association, 2022). Screening tools and laboratory tests Her presentation might appear psychiatric, but psychiatric screening tools and focused laboratory investigations help establish a diagnosis and rule out medical causes. The GAD-7 has been validated to measure severity of anxiety for this case. The PHQ-9 can assess any simultaneous chronic depressive symptoms. The severity of finger-biting behavior can be assessed using the Y-BOCS-BFRB or the Habit Questionnaire. The Insomnia Severity Index is a suitable instrument for sleep disturbances. To evaluate fatigue, a CBC is a standard lab test. Specifically, a thyroid panel helps to rule out any thyroid issues that may be causing anxiety. Test for vitamin D and B12, together with a complete metabolic panel, is performed to investigate causes of fatigue or mood (American Psychiatric Association, 2022). Differential Diagnoses DSM5TR & ICD10CM Codes for Differential Diagnoses:• Excoriation (SkinPicking) Disorder – DSM5TR: 698.4 | ICD10CM: L98.1• Adjustment Disorder with Anxiety – DSM5TR: 309.24 | ICD10CM: F43.22 (American Psychiatric Association, 2022). It is likely that she has "excoriation disorder" since she continues to bite her fingers which causes damage. On the other hand, her behavior actually gets worse when she’s stressed out, but it is not a consistent compulsive thing. Adjustment disorder with anxiety could be another possibility given that the symptoms of the patient started soon after the life change of graduate school. While there is a timing relationship noted, the severity and intensity of her symptoms, which include a broad range of anxious symptoms, sleep difficulties, trouble focussing, and fatigue are greater than what would have been expected with an adjustment disorder so a diagnosis of generalized anxiety disorder fits better (American Psychiatric Association, 2022). Working Diagnosis: Generalized Anxiety Disorder (GAD) (American Psychiatric Association, 2022). DSM-5-TR Code: 300.02ICD-10-CM Code: F41.1 The individual has generalized anxiety disorder according to DSM-5-TR. The patient expresses an intense, pervasive fear of failing academically and difficulty controlling her anxiety. She additionally complains of feeling agitated, difficulty concentrating, insomnia and fatigue. Symptoms have been present on most days and causing her significant interference with function and distress. The correct diagnosis is generalized anxiety disorder (GAD) (American Psychiatric Association, 2022). Pharmacological Interventions Since she is so symptomatic, medication is recommended. Sertraline is a favorable initial treatment option of selective serotonin reuptake inhibitors. Start by taking 25 mg a day during the first week. If there are no side effects, the dose can then be titrated to 50 mgs. Clinical data indicate that sertraline is effective, safe and well tolerated for the treatment of generalized anxiety disorder in younger patients. Hydroxyzine can also be given short-term, particularly if symptoms are interfering with sleep, while waiting for the selective serotonin reuptake inhibitor (SSRI) to take effect. Wait four to six weeks and then when continuing on to the...