Diagnosis and treatment: A patient came to a psychiatrist’s office and described
ID: 177107 • Letter: D
Question
Diagnosis and treatment:
A patient came to a psychiatrist’s office and described the following symptoms:
He has trouble focusing on the things he needed to do, and get distracted very easily. He often
got projects started but never finished them, or forgot about them completely. He is very restless;
never sits still, and fidgets a lot. He acts very impulsively, and often jumps before he thinks that got
him into a lot of troubles. He is often very reactive, emotional and has difficulties with work and
interpersonal relationship currently. He remembered that he was a frequent visitor at the
principal’s office when he was in school. He is an adult now, but had never been diagnosed with
any disorder before because his family did not have any medical insurance to pay for doctor’s visits.
Now, since he realized he got into so much trouble in his life, he is wondering if he may have a
disorder that had not been diagnosed since his childhood that needed some medical attention badly.
He is seeking medical help.
a. If you were the psychiatrist, based on the symptoms, what disorder is he likely to have? What are the
characteristics of this disorder?
b. What are other similar disorders? Explain how you eliminate these other similar disorders based on
the characteristic symptoms.
c. What neurotransmitter system is involved in this disorder? Which part of the brain is affected?
Explain the relationship between the neurotransmitter and the brain functions affected by deficiency
of such neurotransmitter.
d. What pharmacological treatments would you prescribe? Explain what neurotransmitter system these
drugs act on to treat this disorder.
Explanation / Answer
Ques-a. If you were the psychiatrist, based on the symptoms, what disorder is he likely to have? What are the
characteristics of this disorder?
He has symptoms such as forgetfulness, lack of attention on working projects, restless & never sits still, and fidgets a lot. He acts very impulsively, and often jumps before he thinks that got him into a lot of troubles. He is often very reactive, emotional and has difficulties with work and interpersonal relationship currently. These symptoms are representing that he has undiagnosed "Attention deficit hyperactivity disorder (ADHD)". This is a psychological disorder mainly a neurodevelopmental type during childhood
Ques-b. What are other similar disorders? Explain how you eliminate these other similar disorders based on the characteristic symptoms.
Autism spectrum disorder, insomnia, excessive stress disorder are other similar disorders and you can eliminate these disorders by early diagnosis based on the characteristic symptoms. Behavioral therapy and medication is essential to prevent these
Ques-c. What neurotransmitter system is involved in this disorder? Which part of the brain is affected?
Dopamine in mesolimbic pathway and norepinephrine in locus cerulus with affected midbrain limbic -straital system
Ques-d: Explain the relationship between the neurotransmitter and the brain functions affected by deficiency of such neurotransmitter.
The noradrenaline levels are reduced with higher cholinergic activity result in more motor activity and the other brain functions including memory, spatial memory are affected due to affected amygdala & hippocampus. The other seratoneric, glutamatergic, or cholinergic pathways are disturbed due to imbalance