St Thomas University Health & Medical Clinical Case Discussion

Ms. Z is a 28-year-old assistant store manager who arrives at your outpatient cliniccomplaining of sadness after her boyfriend of 6 months ended their relationship 1 month ago.
She describes a history of failed romantic relationships, and says, “I don’t do well with
breakups.” Ms. Z reports that, although she has no prior psychiatric treatment, she was urged
by her employer to seek therapy. Ms. Z has arrived late to work on several occasions because of
oversleeping. She also has difficulty in getting out of bed stating, “It’s difficult to walk; it’s like my legs
weigh a ton.” She feels fatigued during the day despite spending over 12 hours in bed and is concerned
that she might be suffering from a serious medical condition. She denies any significant changes in
appetite or weight since these symptoms began.
Ms. Z reports that, although she has not missed workdays, she has difficulty concentrating and
has become tearful in front of clients while worrying about not finding a significant other. She
feels tremendous guilt over “not being good enough to get married,” and says that her close
friends are concerned because she has been spending her weekends in bed and not
answering their calls. Although during your evaluation Ms. Z appeared tearful, she brightened
up when talking about her newborn nephew and her plans of visiting a college friend next
summer. Ms. Z denied suicidal ideation.
Remember to answer these questions from your textbooks and clinical guidelines to create
your evidence-based treatment plan. At all times, explain your answers.
1. Summarize the clinical case including the significant subjective and objective data.
2. Generate a primary and two differential diagnoses. Use the DSM5 to support the
assessment. Include the DSM5 and ICD 10 codes.
3. Discuss a pharmacological treatment would you prescribe? Use the clinical guidelines to
support the rationale for this treatment.
4. Discuss non-pharmacological treatment would you prescribe? Use the clinical guidelines
to support the rationale for this treatment.
5. Describe a health promotion intervention that would be appropriate for this patient.

Your initial post should be at least 500 words, formatted, and cited in current APA style with
support from at least 2 academic sources. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts.

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