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Case study Assignment on Substance Use Disorder

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Case study Assignment on Substance Use Disorder

Erik is a 19-year-old culinary school student who presented with his mother, complaining of anergia (abnormal lack of energy) and difficulty concentrating. He refused to have his mother present during the intake assessment. Erik does not want to sign the medical release form, stating that it can work against him. He reports that he was fired from a restaurant three months ago after being caught drinking wine left on a table. He claims that he was tricked to drink the alcohol by his coworkers. Not long after the incident, he stopped going to school and sleeps during the day and stays out all night to hang out with friends until the last month. He broke up with his girlfriend a few weeks ago and stopped hanging out with friends. He says they were bad-mouthing him. He also reports that he is afraid to sleep at night because he can hear them talking about him.

Erik started drinking at 12, and his drinking gradually increased over the years. He now drinks secretively at home when his parents are not around. He started smoking marijuana at 15 and used to smoke only with friends. Lately, he uses it almost every day and leaves home only to buy joints. He used up most of his money saved for tuition. He denies using any other illegal drugs or prescribed medications for non-medical use.

Erik does not have any prior psychiatric history and denies family history except that his father drinks alcohol almost every day and one of his cousins was diagnosed with ADHD. He is asking whether he might have the same problem and if he can have the same medication that his cousin takes. He has no acute medical concerns, no chronic conditions and is not on any medications, herbal, or dietary supplements. Erik is in your office today and mildly agitated after you explained the lack of support for him having an ADHD diagnosis.

Please answer ALL questions below as your initial or original post. Initial posts and responses must be based on various resources such as textbooks, articles, and journals. Medscape, Up-to-Date, and ePocrates as supplemental resources are acceptable. 

1) Using the DSM V diagnostic criteria and hallmark symptoms, what is the diagnostic possibility that is most appropriate for this case study? What would substantiate and differentiate the diagnosis? (Please refer to the diagnostic criteria and exclusionary criteria in the DSM to answer this question).

2) Please discuss other related conditions (at least two differential diagnoses) which may need to be ruled out or can be ruled out and why/how as outlined in the DSM. This is an important section as it justifies your clinical impression by walking your faculty through your diagnostic decision making.

3) What psychosocial and environmental problems are important to consider in this case in terms of treatment and prognosis of this identified mental disorder?


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