Jeanie is a 32-year-old male presenting to

Jeanie is a 32-year-old male presenting to the clinic after being referred by his primary care provider. working as a business analyst in Northern VA. She is a graduate of UPenn with a degree in finance. Currently, Jeanie has been struggling with excessive anxiety and worry for the past several months and it has been impacting her personal and professional relationships. Jeanie reports that she has been double-checking her reports to the point of handing them in late. She states that she is worried that she will make a mistake. Logically, Jeanie knows that this sounds unreasonable as she has always been a top performer and cannot think of a time she had been reprimanded at work. Her excessive worry has also been negatively impacting her relationship with her boyfriend. Jeanie states that she has found it difficult to go out in public and has not been able to go out to restaurants because of how uncomfortable she feels. She states that she spends her time worrying and can’t focus on the experience. Jeanie reports feeling wound up and irritable throughout most of the day. She states that she often feels fatigued and struggles with muscle tension. She has difficulty falling asleep and staying asleep due to her excessive worrying about, “anything and everything.” Jeanie’s symptoms have been well-managed for years on her current medication, but she would like to taper off her current medication to address her breakthrough symptoms. As per mood, the patient denies tearfulness, guilt, and neurovegetative signs and symptoms such as changes in energy, sleep, and concentration. Patient denies Si/Hi. The patient denies screening questions to melancholic depression such as early morning awakenings, a mood that is worse in the morning, or anorexia. The patient denies atypical depressive screening questions such as weight gain, hypersomnia, or sensitivities to interpersonal rejection. The patient denies screening questions to mania such as cyclical irritability, anger, grandiosity, distractibility, pressured speech, racing thoughts, or sleep difficulties. Patient denies screening questions to psychosis such as auditory or visual hallucinations., ideas of reference, and paranoia; denies thought broadcasting, thought withdrawal, persecution, and control. How would you diagnose this patient (may have up to 2 diagnoses)? Please defend your answer with criteria from DSM-5-TR. (15 points) Provide two differential diagnoses with an explanation and rationale on why you chose those diagnoses. Please use your DSM-5-TR/course materials to explain your selection for differential diagnoses (10 per differential total of 20 points) Provide appropriate patient education and clinical pearls for the diagnosis you selected. (15 points) Extra Credit 2-point bonus (per case up to 4 points): Provide a treatment plan for this patient to include medication and other interventions. The more specific you are in your treatment plan the more points will be awarded. SCIENCE HEALTH SCIENCE NURSING NURS 468

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