Previous Multi-Axial Diagnostic Impression
Axis I: F43.10 Posttraumatic Stress Disorder; F20.9 Schizophrenia, unspecified
F12.20 Cannabis Use Disorder, Severe; F15.20 Amphetamine-type substance, severe
Axis II: None
Axis III: None
Axis IV: relationship issues, financial issues, legal issues
Axis V: GAF: 75
Current Multi-Axial Diagnostic Impression
Axis I: F43.10, 309.81 Posttraumatic Stress Disorder, Unspecified
Axis II: None
Axis III: None
Axis IV: relationship issues, financial issues, legal issues
Axis V: GAF: 75 David presented with an Axis I disorder of Schizophrenia, unspecified prior to my first session with him. After my intake and after gathering more information upon the third session, I disagreed with the prior clinician’s diagnosis. During the sessions, I discovered that the client reported no “delusions or hallucinations” since his initial report of possibly seeing flashing lights and hearing radio chatter (American Psychiatric Association, 2013, pg. 99). He also had speech that was not considered “disorganized” and had “expressive emotions” when talking in session (American Psychiatric Association, …show more content…
My clinical assessment ruled out Antisocial Personality Disorder, F60.2, based on my interview and observations. Though David is in legal trouble and at Work Release, he has displayed “social norms with respect to the law” (American Psychiatric Association, 2013, pg. 659). David has not been “deceitful and has been honest with those he is in contact with, and has honored his work behavior and financial responsibilities” since entering Work Release. During our sessions my client has shown “remorse” for the multitude of laws he broke, things he stole, and drugs he took in the past (American Psychiatric Association, 2013, pg. 659). Because of the evidence shown in session, I felt a diagnosis of Antisocial Personality Disorder would not be of benefit in his current