Case #5: The Case of Elliott Elliott is a 67-year-old man who recently retired as the president of a large company where he had worked for the last 25 years. The Board of Trustees held a testimonial dinner for him during his last week at work. At the dinner several speakers stood up to praise his wise leadership of the company during difficult economic times. Elliott thanked them all for their kind words and explained that he was looking forward to relaxing and doing nothing for the next several months. One Board member yelled, "Sure Elliott, you're going to sit home and knit for 6 months." The audience laughed and Elliott smiled. Elliott spent the next couple of days cleaning out his office. He began to feel a little depressed when he noticed that his secretary and staff were already accommodating to his departure. They were polite but seemed somewhat distant and were preparing for the new president. On his last day, Elliott walked around the main office and personally said good-bye to everyone. One administrator commented, "I wish I could retire and play golf all day like you." Elliott smiled but felt a queasy sensation in the pit of his stomach accompanied by some anxiety. He went home that night feeling mildly depressed and anxious about what he would do for rest of his life. The next morning, he woke up early, had breakfast, and went to his club to play golf with three business colleagues. The group played nine holes of golf, showered, and had lunch. When they finished, Elliott suggested they take a walk. One of the men laughed and said, "You're a free man Elliott. We're still part of the daily grind. I have to go back to the office." The men left and Elliott took a short walk around the grounds of the club. He felt restless and irritable. That night he had little appetite for dinner and difficulty falling asleep. He woke up at 4:30 A.M. feeling anxious, worried, and depressed about his future. Elliott avoided the club and his business friends for several weeks. He sat home and watched television, but found it difficult to sit still for more than a few minutes. Elliott's wife observed her husband's behavior for several weeks. She suggested they take a vacation or visit their children. Elliott was not interested. Finally, one night at dinner, she said, "I think you're upset about retiring. You need to find something useful to do with your life." Elliott was irritated at first by her comments and then nodded. "This isn't what I expected retirement to be like," he said.

Directions for Activity You are to read each of the five cases in this exercise and then utilize the DSM-5 and ICD-9-CM and ICD-10-CM codes to identify what are the Principle, Provisional and Other Conditions That May Be a Focus of Clinical Attention in each case.

There will be more than one correct answer

Case #5: Elliot Principle Diagnosis a) _____309.81 (F43.10) Posttraumatic Stress Disorder b) _____309.0 (F43.21) Adjustment Disorder with depressed mood c) _____300.00 (F41.9) Unspecified Anxiety Disorder d) _____296.21 (F32.0) Major Depressive Disorder Single episode with anxious distress