Oscar Treatment Case Study
Identifying Information
Oscar is a 19-year-old Hispanic male, currently a freshman at a college majoring in agriculture. He is the eldest of five children in a family that has been farming the same land for four generations. His family grows vegetables for a regional grocery chain and lives in a rural area of the county. The family is very close-knit and highly independent, with three generations living in two separate houses on their land. Despite their strong family bonds, they have minimal interaction with people outside their family, preferring to maintain their independence from the local town’s community.
Oscar has always been seen as a responsible and hardworking individual, traits instilled in him by his family’s farming background. His commitment to carrying on the family tradition of farming and his enrollment in college to study agriculture demonstrate his dedication to this goal. However, recent behavioral changes have raised significant concerns among his family members, leading to his current treatment at a residential facility.
Presenting Problem
Oscar’s parents observed drastic changes in his appearance and behavior when he returned home for spring break. He had lost a noticeable amount of weight, looked physically exhausted, and exhibited signs of sleep deprivation. His mood was markedly different; he was irritable, argumentative, and no longer engaged in regular family activities. Oscar expressed a strong reluctance to return to college, citing paranoia that his roommate had placed cameras in their room to record his actions and that his professors were prejudiced against him. These concerns were accompanied by a significant decline in his academic performance, which was a stark contrast to his high school achievements where he was among the top 10% of his class.
In addition to these changes, Oscar began exhibiting unusual behaviors. He stopped showering, started wearing multiple layers of clothing regardless of the weather, and became almost completely non-communicative. He isolated himself in his room, avoided family meals, and only left his room in the middle of the night to wander around the house and property. His family, deeply disturbed by his behavior, sought advice from their priest, who recommended professional counseling. This led to Oscar’s hospitalization and the beginning of his formal mental health assessment and treatment.
Oscar Treatment Case Study
Previous Treatments
Oscar’s initial treatment involved a diagnosis of major depressive disorder, single episode, severe with psychotic features. He was prescribed antidepressants and hospitalized for three weeks. During this period, he showed some signs of improvement but relapsed shortly after being discharged. Upon his second hospitalization, it became evident that the initial diagnosis did not fully capture the severity and nature of his symptoms.
During his second stay, his condition was reassessed. He exhibited continued non-communicative behavior, persistent delusions, and paranoia. The discovery of a cache of knives and delusional notes about harming his siblings further indicated the presence of severe psychotic symptoms. This prompted a revised treatment plan that included antipsychotic medication. The re-assessment revealed that Oscar’s symptoms were more consistent with a diagnosis of schizophrenia rather than major depressive disorder with psychotic features.
Oscar Treatment Case Study
Strengths, Weaknesses, and Social Support Systems
Strengths
Family Support: Oscar’s family is deeply committed to his well-being, providing emotional support and actively participating in his treatment decisions. Their close-knit nature means that Oscar has a strong, reliable support system.
Motivation for Improvement: Despite his severe symptoms, Oscar has shown moments of clarity and willingness to communicate with his treatment team, indicating a desire to improve his condition.
Insurance Coverage: The family’s medical insurance through the farmer’s co-op covers residential treatment for up to a year, ensuring that Oscar has access to the necessary long-term care without financial strain.
Weaknesses
Social Isolation: Oscar has minimal social interactions outside his immediate family, which can hinder his social development and limit his support network. His lack of friends and social activities outside the family contribute to his isolation.
Severity of Psychotic Symptoms: Oscar’s hallucinations and delusional thoughts present significant challenges to his treatment and daily functioning. These symptoms have led to behaviors that are disruptive and potentially harmful.
Communication Barriers: Oscar’s tendency to withdraw and provide minimal responses makes it difficult for healthcare providers to fully understand his experiences and needs, potentially slowing his treatment progress.
Social Support Systems
Family: Oscar’s parents and grandparents are actively involved in his care, providing a consistent and supportive presence. Their commitment to his recovery is evident in their willingness to seek professional help and participate in his treatment.
Religious Community: The family’s priest has been a source of guidance and support, offering spiritual and emotional comfort during this challenging time.
Residential Treatment Facility: Oscar has access to a multidisciplinary team of professionals, including counselors, a psychologist, and a psychiatrist. This team approach ensures that he receives comprehensive care addressing his diverse needs.
Oscar Treatment Case Study
Assessment
Oscar’s assessment began with a comprehensive evaluation by his treatment team during his initial hospitalization. This included detailed interviews with Oscar and his family, a review of his medical and psychiatric history, and observations of his behavior. The initial diagnosis of major depressive disorder with psychotic features was based on his reported symptoms of paranoia, hallucinations, and severe depression.
However, his re-admission and subsequent behaviors led to a re-assessment. The discovery of knives, delusional notes, and Oscar’s detailed accounts of auditory hallucinations provided new insights into the nature and severity of his condition. These additional findings indicated that Oscar was experiencing persistent and severe psychotic symptoms, warranting a diagnosis of schizophrenia. The re-assessment involved further interviews, psychological testing, and consultations with the treatment team to develop a more accurate and effective treatment plan.
Diagnosis
Oscar’s revised diagnosis is Schizophrenia, characterized by the presence of persistent auditory hallucinations, delusional thoughts, social withdrawal, and significant impairment in daily functioning. This diagnosis is supported by his symptoms, including the belief that he needs to protect his family from perceived threats, hearing voices giving him instructions, and his severe behavioral changes since the onset of his condition.
The diagnosis of schizophrenia also aligns with the family history of similar symptoms, as indicated by the grandfather’s brother who experienced religious visions and later died under mysterious circumstances. This genetic link further supports the diagnosis and underscores the importance of a comprehensive treatment plan that addresses both the psychotic symptoms and the underlying genetic predisposition. APA.
References
American Psychiatric Association. (2013). *Diagnostic and statistical manual of mental disorders* (5th ed.). Arlington, VA: American Psychiatric Publishing.
Kaplan, G., & Sadock, B. (2015). *Synopsis of psychiatry: Behavioral sciences/clinical psychiatry*. Wolters Kluwer.