• The diagnosis should appear on one line in the following order. Note: Do not include the plus sign in your diagnosis. Instead, write the indicated items next to each other.

Code + Name + Specifier (appears on its own first line) Z code (appears on its own line next with its name written next to the code)

respond to the following:

• Explain how you support the diagnosis by specifically identifying the criteria from the case study.
  • Describe in detail how the client's symptoms match up with the specific diagnostic criteria for the disorder (or all the disorders) that you finally selected for the client. You do not need to repeat the diagnostic code in the explanation.
• Identify the differential diagnosis you considered.
• Explain why you excluded this diagnosis/diagnoses.
• Explain the specific factors of culture that are or may be relevant to the case and the diagnosis, which may include the cultural concepts of distress.
• Explain why you chose the Z codes you have for this client.
  • Remember: When using Z codes, stay focused on the psychosocial and environmental impact on the client within the last 12 months.

Which diagnosis fits the case study?

American Psychiatric Association. (2022).Diagnostic and statistical manual of mental disorders (DSM-5-TR)(5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

"Schizophrenia Spectrum and Other Psychotic Disorders" (pp. 101-138) Note:Review this entire classification.

Section III, "Culture and Psychiatric Diagnosis" (pp. 859-879)

CASE of JEREMIAH

INTAKE DATE: August xxxx

IDENTIFYING/DEMOGRAPHIC DATA: Jeremiah is a 24 year old Israeli male. Jeremiah's religion is Jewish. He is single and attending the University of Maine for his Masters Degree in Finance. Jeremiah was born and raised in Tel Aviv, Israel Jeremiah and came to the United States 2 years ago.

CHIEF COMPLAINT/PRESENTING PROBLEM: Over the past three monthsJeremiah reported he hadauditory hallucinations of an angel's voice, suspiciousness, ideas of reference and hostility, and moderately severe conceptual disorganization. Patient tried to kill his roommate by suffocation - claiming that he heard fireflies tell him the roommate is influenced by Satan.

HISTORY OF PRESENT ILLNESS: In the last several weeks,Jeremiah began to become socially withdrawn (keeping himself in his room), had signs of disorganized speech & thought. Jeremiah began spending his time browsing and chatting in Facebook about God and UFO's. He would spend too much time online until he passed out.

PAST PSYCHIATRIC HISTORY: Jeremiah denies any past psychiatric history.

SUBSTANCE USE HISTORY: Jeremiah denies any use of illicit drugs. He does report occasional use of alcohol. He has been drunk as a teenager but prefers not to indulge that much.

PAST MEDICAL HISTORY: Jeremiah had been admitted to a hospital to get treatment as his wrist was injured due to a suicide attempt, six weeks ago.

FAMILY MEDICAL AND PSYCHIATRIC HISTORY: Jeremiah is the second from five siblings. One of his family members has mental illness (schizophrenia), but would not identify the family member.

CURRENT FAMILY ISSUES AND DYNAMICS (OPTIONAL):Jeremiah attends school for finance. His family continues to reside in England. His parents are very supportive of his attendance at an American school. Jeremiah is able to socialize with other students and professors. He engages in leisure activity such as surfing the Internet, keeps his room tidy, doing household activity such as washing clothes, and kitchen preparation.

MENTAL STATUS EXAM: Jeremiah appeared disheveled with poor hygiene. He was properly attired with hospital attire and had adequate eye contact. Jeremiah was able to cooperate during interview. There were some signs of anhedonia, inappropriate behavior. He raised his voice at one time during the interview. His mood was irritable with upset speech. He was not coherent at times. Sometimes there appeared irrelevant talk. Thoughts were preoccupied with obsessions, and persecutory delusions. Perceptions showed auditory hallucinations. He was oriented: able to state person, place and time correctly. His short term memory was intact: able to retrieve games rule. His long term memory was good: able to recall previous history. Insight was good.