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A brief hypothetical case history on PD
Typology: Cheat Sheet
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DEMOGRAPHICS: Madhav Dubey., a 42-year-old male accountant, from upper middle socio-economic status
INFORMANT: Patient & his wife; staying with the patient since the last 16 years
Most of his anger outbursts erupted and lasted only for a few seconds and a few are followed by grumbling and shouting for about 10 min. Anger resulted in yelling with angry gestures, banging, crumpling, throwing, tearing and breaking of objects
CHIEF COMPLAINTS: M.D. came to therapy reluctantly at the urging of his wife, who expressed concern about his constant arguments with co-workers and his refusal to let their teenage son spend time with friends. He also reported that he has several fears but insisted there was nothing wrong with him and that everyone else was out to get him.
DURATION & COURSE OF ILLNESS: Lifelong and progressing
FACTORS:
HOPI: M.D. reported a lifelong pattern of suspicion and distrust towards others. He believed co-workers were stealing credit for his work and that his boss was deliberately trying to sabotage him. He would hold onto minor slights for years, interpreting them as evidence of hidden agendas. These suspicions made it difficult for him to maintain positive relationships at work. At home, M.D. constantly monitored his son's activities, fearing he would be influenced by bad people. This smothering behavior strained their relationship.
NEGATIVE HISTORY: OCPD, BPD, Adjustment Disorder, Phobia or Anxiety
PAST HISTORY:
SOCIAL HISTORY: M.D. had few close friends and struggled to maintain friendships due to his mistrust. He rarely socialized outside of work and expressed a general dislike for most people.
Family History: M.D.'s father was a very critical and controlling man who often accused M.D. of lying or doing things wrong. M.D. reported feeling like he could never do anything right in his father's eyes. There was no family history of mental illness otherwise.
Treatment Plan: Individual therapy focused on:
Cognitive-behavioral therapy (CBT) to identify and challenge distorted thinking patterns related to suspicion and mistrust. Improving social skills and communication to build healthier relationships. Learning to manage anger and defensiveness. Developing insight into how his behavior affects others.