Please help, im doing an assignment on Psychiatry. - xoxo

Im doing an assignment and its on psych, im getting lost because I don't know if I have to do between the tests , or . or? can someone just explain the rules my teacher never went over this, thanks for the help it's greatly appreciated;

This current psychological evaluation, including a review of intellectual and memory processing was obtained in part, to evaluate for Social Security Disability services.

Tests administered:

Wexler adult intelligence scale. (WAIS)

Revised Wexler adult intelligence scale (WAIS-R)

Wexler memory scale.

BACKGROUND HISTORY:

Patient presents with a chief complaint "Where I was working several months ago they advised me to do this". She indicated that she is not currently employed as result of significant difficulties with asthma, as well as a sciatic pain in her right side. Patient spoke in extremely low voice. She lossed her voice approximately 2 years ago due to "a very bad infection". She elaborated by indicating that "Physician’s never figured it out". And apparently medications were not helpful.

She has been treated for asthma, bronchitis and significant cough. Patient has been unemployed since August because, “I got fired because I don't talk enough". She was fired from a medical assistant position according to her report. Patient indicates that over the years," I lost a lot of my people skills". The patient has experienced intermittent depression since undergoing chemotherapy and cobalt treatments for breast cancer about 3 years ago

MEDICATIONS:

Current medications include; Proventil inhaler for asthma, sinus washes, and cough drops as well as half tablets of Tylenol 3 for cough. She is also taking for sciatic. Patient notes erratic sleep and some energy disturbance. She has had trials of Prozac, Zoloft and Welbutrin.

BEHAVIORAL OBSERVATION:

Vocabulary is intact, although speech is extremely soft and at times almost inaudit.Tracking and conversations are within normal limits with no associations, circumstantialities no tangentially and thought processes. Articulation is good. Her appearance is obese, casual grooming, humor was generally good. She is generally a good historian, although at times is vague. General demeanor is polite and cooperative. The patient is alert and oriented to time, person, place, situation and clear sensorium.

She denies auditory or visual or factory or tactile hallucinations, delusions of reference, grandiosity or persecution. Since of reality testing intact with no schizophrenia thought processes. Persecution or receiving special messages from TV/radio. She currently denies suicidal ideation or plan, although has had some cluding suicidal thinking. Inside and judgment is fair.

TEST RESULTS:

Intellectual functioning, (WAIS). Verbal sub tested information, 8. Digit span, 12. Vocabulary, 12 arrhythmatic, 14 comprehension, 10 similarities, 12.

PERFORMANCE SUB-TEST:

Picture completion,11, picture arrangement , 12 ,block design,10 , object assembly ,12, digit symbol, 11, verbal IQ is 107, performance IQ is 107,full scale IQ is 106. Overall patient is functioning with the average rage of general intellectual abilities. IQ 106 (65 percentile). Her comprehension skills are within the normal range as are right hemisphere perceptional organizational skill, performance skills was 107, (86 percentile). There are no significant differentials observed between left 106 and left 107.

The patient's highest scale scored is 90. Within the domain of oral arrhythmatic ability (91 percentile). High average scales are noted in the domain of numeric concentration, EG 7 digit forward and 6 digit backward (75 percentile). High average abilities are also noted in the general vocabulary of written knowledge, commonalities between object. Sequencing of skills and visual analytical skills for noble stimuli (75 percentile). Average skills are noted on measured visual and remote memory. Block construction skills and alertness for details in her environment comprehension skills (50-63 percentile). Patient's lowest scores are noted on general fond of information (25 percentile). Overall patient's intellectual skills are within average range if IQ 106.

On the Wexler and memory scale 1 (WMS-1). The patient demonstrated fine performance. Information, 5 orientation ,5 mental control,7 memory passage,7.5 digits total,13 visual reproduction,13 associate learning,19MQ,122.

DIAGNOSTIC IMPRESSION: Axis I. dysthymia. Axis II. Deferred. Axis IV. Asthma, chronic sinusitis, chronic bronchitis, chronic cough. Status post left mastectomy hysterectomy. Status post chemo therapy and Cobalt therapy right side sciatic pain.  Axis V. Moderate, Axis VI. Current fluid intelligence (Gf, 43)

TREATMENT PLAN AND RECOMMENDATION:

1. The patient is able to manage her own funds given that her oral arrhythmatic scores are within superior range (90 percentile).

2. The patient does have difficulties with self expression due to low voice volume, which would interfere with social interactions’ and communication and job placement. This makes her a poor candidate for returning for work and apparently is one of the reasons for her being fired.

3. Continue evaluation of her complex medical history and refer it to internal medicine.

4. Possible supportive therapy to health center for, underlying dysthymia decreased self confidence.