懇請精神科醫師幫忙, 謝謝 , 呼叫歐老師幫幫忙

[DR.5]

孩子的作業
懇請論壇上的大大幫忙
謝謝

Consider the following case history:
Dr. Robin was a 45 year-old thoracic surgeon, the outstanding investigator at the major teaching hospital of a famous medical school. Not only was he an innovative research surgeon, but he was also active on national advisory committees, a prolific author, an accomplished and dedicated sailor and the father of three teenagers. The Psychiatry Department knew him through his enthusiastic adoption of a transiently popular psychobiological theory of human
nature, which emphasized the biological determinism of such human features as aggression, territoriality, etc.
His contact at the Department of Psychiatry acknowledged the articulate logic of Dr Robin’s several thousandpage essay on the topic of man's nature, but discouraged him from anticipating that the field of Psychiatry would make the radical transformation in theory and practice which he demanded. Dr. Robin realized that this attitude reflected not just the stupidity and arrogance of psychiatry, but was evidence of the widespread plot amongst the senior faculty to demean him. Further evidence was found in the fact that 2 or 3 really novel surgical interventions that he had planned had been forbidden by the Chief of Service. He became increasingly agitated about this plot, and had a few episodes of loud, accusatory yelling in the office of the hospital director, as well as the office of the Chief of Surgery. He turned out, on investigation, to also be persuaded that his wife was cheating on him, and though he had moved out of the family home, was picked up by the police on two occasions hiding in the garden and watching the house at night.
The hospital administration felt it necessary to cancel his hospital privileges and reported to the state medical secretary, raising the question as to whether his license to practice medicine should also be suspended. He promptly retained a prominent attorney and mounted a vigorous, clever and articulate counter-attack.
Within the next few weeks, both the family and the hospital staff became anxious enough about his unpredictable outbursts of rage that they asked his friend in psychiatry to attempt hospitalization. Dr. Robin was admitted to a private psychiatric hospital to the closed and locked ward, where for several days he was in emotional turmoil. He paced the floor, shouted, was sleepless, and in particular, gave vent to attacks on all the various persons and groups plotting against him--his wife, his children, his colleagues. By the fifth day, this turmoil abated. He returned to his basic, articulate,
rather charming self, and he set about organizing, with his attorney, a habeas corpus appeal that was ultimately successful (i.e., the hospital was forced to release him). The court organized a peace bond to prevent him approaching his wife, and the state medical board suspended his license to practice. He subsequently moved to another state, got another license, remarried and has become a prominent leader in a different medical specially. He continues to have idiosyncratic and strong beliefs about the nature of man.


Based on this information alone, provide two (2) diagnoses for Dr Robin. In other words, what are the two mental illnesses this individual is most likely suffering from? Of the two diagnoses you
provide, which diagnosis do you believe is the most accurate? Why is it important to diagnose
accurately? Justify your responses.

[newshine]

這是啥啊
看不下去了


落落長

[brian1968]

這是啥啊
看不下去了


落落長

因為您不是當科的














我也不是

[superdog]

英文+精神科= ......

[newshine]

英文+精神科= ......

說英語的精神病患嗎

[superdog]

英文+精神科= ......

說英語的精神病患嗎

論壇歐老師啦 ...

[superdog]

Borderline personality ? inpulsive type ?
Bipolar ?

[DR.5]

Borderline personality ? inpulsive type ?
Bipolar ?

感恩

其實在我腦海中的精神病名沒幾個
我也不知如何幫我的孩子
孩子今年大一, 念的是science
這是選修課的作業
每個禮拜都有一份厚厚的精神科paper
念完寫心得或問答
這禮拜的作業最短只有一頁卻是最難

[superdog]

龍五哥，嘜講多謝啦。偶是來亂的。歹勢
等歐老師還是羊ＭＭ卡實在

而且..... 是最討厭的申論題，不是簡答題~~

[lotus425]

Based on the passage, I would diagnose him based on the DSM IV criteria as having
1. Bipolar personality (manic episode). Due to public display of outrage, inflated self-esteem and display of grandiosity.
2. Paranoid personality disorder- (DSM-IV code 301.0): characterized by irrational suspicions and mistrust of others. (wife cheating on him; colleagues turning their back against him).

Not a psychiatrist myself but came up with the above diagnoses. Do some reading on DSM IV diagnosing criteria. I am sure you can find a better diagnosis for this patient.

不好意思 不是精神科隨便回答。英文很熟悉 小弟在美國長大 英文比中文好 算是半個ＡＢＣ。在洛杉磯行醫數年。 近年來搬到台北成功考取醫師執照目前在台北東區松山區 地區醫院擔任皮膚科主治醫師。

[DR.5]

Based on the passage, I would diagnose him based on the DSM IV criteria as having
1. Bipolar personality (manic episode). Due to public display of outrage, inflated self-esteem and display of grandiosity.
2. Paranoid personality disorder- (DSM-IV code 301.0): characterized by irrational suspicions and mistrust of others. (wife cheating on him; colleagues turning their back against him).

Not a psychiatrist myself but came up with the above diagnoses. Do some reading on DSM IV diagnosing criteria. I am sure you can find a better diagnosis for this patient.

不好意思 不是精神科隨便回答。英文很熟悉 小弟在美國長大 英文比中文好 算是半個ＡＢＣ。在洛杉磯行醫數年。 近年來搬到台北成功考取醫師執照目前在台北東區松山區 地區醫院擔任皮膚科主治醫師。

感恩

[brian1968]

英文+精神科= ......

說英語的精神病患嗎

論壇歐老師啦 ...

[superdog]

英文+精神科= ......

說英語的精神病患嗎

論壇歐老師啦 ...

　罰偶去（生日快樂版）思過

[DR.5]

英文+精神科= ......

說英語的精神病患嗎

論壇歐老師啦 ...

　罰偶去（生日快樂版）思過

思過後要寫報告

[superdog]

　罰偶去（生日快樂版）思過

思過後要寫報告

沉迷在生日快樂版的症頭，這一題我會：

ICD-10 F52.7 Excessive sexual drive: Satyriasis

[wipten]

歐 買 尬 的 ............

[lupin]

(1) Bipolar I disorder
(2) delusional disorder

此患者最好不要把 personality disorder擺在前面

[DR.5]

(1) Bipolar I disorder
(2) delusional disorder

此患者最好不要把 personality disorder擺在前面

謝謝魯賓校長

[ulian]

(1) Bipolar I disorder
(2) delusional disorder

此患者最好不要把 personality disorder擺在前面

agree +1

[歐伊斯特拉夫]

Sorry being on this tribune so late, I prefer to reply in personal message.

[DR.5]

Sorry being on this tribune so late, I prefer to reply in personal message.

謝謝

[sa460624]

Based on the passage, I would diagnose him based on the DSM IV criteria as having
1. Bipolar personality (manic episode). Due to public display of outrage, inflated self-esteem and display of grandiosity.
2. Paranoid personality disorder- (DSM-IV code 301.0): characterized by irrational suspicions and mistrust of others. (wife cheating on him; colleagues turning their back against him).

Not a psychiatrist myself but came up with the above diagnoses. Do some reading on DSM IV diagnosing criteria. I am sure you can find a better diagnosis for this patient.

不好意思 不是精神科隨便回答。英文很熟悉 小弟在美國長大 英文比中文好 算是半個ＡＢＣ。在洛杉磯行醫數年。 近年來搬到台北成功考取醫師執照目前在台北東區松山區 地區醫院擔任皮膚科主治醫師。

題外話，
大乀，您怎麼會這樣想不開，回來跟我們一齊當賤醫呢？

[superdog]

Sorry being on this tribune so late, I prefer to reply in personal message.

如果可以，是不是可以給個 Hints 或 simple answer 讓我去查書學習一下 ...

[歐伊斯特拉夫]

診斷看法如下

1,Delusional disorder.

2,R/O, Schizophrenia, paranoid type.

3,R/O, Acute stress disorder.

因敘述提供資料顯不足 無法妄下定論

理由如下

1個案是否合併幻覺???? 時間持續6月以上???
2功能或執行業務能力有否大幅下降???
3有無重大生活壓力事件???

[superdog]

感謝，作功課去...

[lotus425]

Based on the passage, I would diagnose him based on the DSM IV criteria as having
1. Bipolar personality (manic episode). Due to public display of outrage, inflated self-esteem and display of grandiosity.
2. Paranoid personality disorder- (DSM-IV code 301.0): characterized by irrational suspicions and mistrust of others. (wife cheating on him; colleagues turning their back against him).

Not a psychiatrist myself but came up with the above diagnoses. Do some reading on DSM IV diagnosing criteria. I am sure you can find a better diagnosis for this patient.

不好意思 不是精神科隨便回答。英文很熟悉 小弟在美國長大 英文比中文好 算是半個ＡＢＣ。在洛杉磯行醫數年。 近年來搬到台北成功考取醫師執照目前在台北東區松山區 地區醫院擔任皮膚科主治醫師。

題外話，
大乀，您怎麼會這樣想不開，回來跟我們一齊當賤醫呢？

哈哈 談戀愛了. 遇到現在的老婆(道地的台灣人)就把LA的診所關了. 台灣真不錯啊 2個孩子可以學到地的國語 台灣話. 美國醫療也快截體了 40%所得稅 超高的醫師保險費. 不忙還真付不起龐大的開業成本. 計畫在待台灣10年. 等孩子學好中文可能再次移民美國. 以我這個美國醫師的角度看台灣醫療. 覺得每一個 醫師都在做公德. 台灣人民真該謝謝這群默默奉獻自己的台灣醫界.

[sa460624]

Based on the passage, I would diagnose him based on the DSM IV criteria as having
1. Bipolar personality (manic episode). Due to public display of outrage, inflated self-esteem and display of grandiosity.
2. Paranoid personality disorder- (DSM-IV code 301.0): characterized by irrational suspicions and mistrust of others. (wife cheating on him; colleagues turning their back against him).

Not a psychiatrist myself but came up with the above diagnoses. Do some reading on DSM IV diagnosing criteria. I am sure you can find a better diagnosis for this patient.

不好意思 不是精神科隨便回答。英文很熟悉 小弟在美國長大 英文比中文好 算是半個ＡＢＣ。在洛杉磯行醫數年。 近年來搬到台北成功考取醫師執照目前在台北東區松山區 地區醫院擔任皮膚科主治醫師。

題外話，
大乀，您怎麼會這樣想不開，回來跟我們一齊當賤醫呢？

哈哈 談戀愛了. 遇到現在的老婆(道地的台灣人)就把LA的診所關了. 台灣真不錯啊 2個孩子可以學到地的國語 台灣話. 美國醫療也快截體了 40%所得稅 超高的醫師保險費. 不忙還真付不起龐大的開業成本. 計畫在待台灣10年. 等孩子學好中文可能再次移民美國. 以我這個美國醫師的角度看台灣醫療. 覺得每一個 醫師都在做公德. 台灣人民真該謝謝這群默默奉獻自己的台灣醫界.

真窩心的一番話，歡迎您全家一起回來陪我們蹲，預祝在這未來l0年光陰，能讓您全家留下美好的記憶。

[台北客]

Based on the passage, I would diagnose him based on the DSM IV criteria as having
1. Bipolar personality (manic episode). Due to public display of outrage, inflated self-esteem and display of grandiosity.
2. Paranoid personality disorder- (DSM-IV code 301.0): characterized by irrational suspicions and mistrust of others. (wife cheating on him; colleagues turning their back against him).

Not a psychiatrist myself but came up with the above diagnoses. Do some reading on DSM IV diagnosing criteria. I am sure you can find a better diagnosis for this patient.

不好意思 不是精神科隨便回答。英文很熟悉 小弟在美國長大 英文比中文好 算是半個ＡＢＣ。在洛杉磯行醫數年。 近年來搬到台北成功考取醫師執照目前在台北東區松山區 地區醫院擔任皮膚科主治醫師。

題外話，
大乀，您怎麼會這樣想不開，回來跟我們一齊當賤醫呢？

哈哈 談戀愛了. 遇到現在的老婆(道地的台灣人)就把LA的診所關了. 台灣真不錯啊 2個孩子可以學到地的國語 台灣話. 美國醫療也快截體了 40%所得稅 超高的醫師保險費. 不忙還真付不起龐大的開業成本. 計畫在待台灣10年. 等孩子學好中文可能再次移民美國. 以我這個美國醫師的角度看台灣醫療. 覺得每一個 醫師都在做公德. 台灣人民真該謝謝這群默默奉獻自己的台灣醫界.

您是王X傑醫師?

[jesuischinoise]

Based on the passage, I would diagnose him based on the DSM IV criteria as having
1. Bipolar personality (manic episode). Due to public display of outrage, inflated self-esteem and display of grandiosity.
2. Paranoid personality disorder- (DSM-IV code 301.0): characterized by irrational suspicions and mistrust of others. (wife cheating on him; colleagues turning their back against him).

Not a psychiatrist myself but came up with the above diagnoses. Do some reading on DSM IV diagnosing criteria. I am sure you can find a better diagnosis for this patient.

不好意思 不是精神科隨便回答。英文很熟悉 小弟在美國長大 英文比中文好 算是半個ＡＢＣ。在洛杉磯行醫數年。 近年來搬到台北成功考取醫師執照目前在台北東區松山區 地區醫院擔任皮膚科主治醫師。

題外話，
大乀，您怎麼會這樣想不開，回來跟我們一齊當賤醫呢？

哈哈 談戀愛了. 遇到現在的老婆(道地的台灣人)就把LA的診所關了. 台灣真不錯啊 2個孩子可以學到地的國語 台灣話. 美國醫療也快截體了 40%所得稅 超高的醫師保險費. 不忙還真付不起龐大的開業成本. 計畫在待台灣10年. 等孩子學好中文可能再次移民美國. 以我這個美國醫師的角度看台灣醫療. 覺得每一個 醫師都在做公德. 台灣人民真該謝謝這群默默奉獻自己的台灣醫界.

您老婆一定是美女

[ulian]

哈哈 談戀愛了. 遇到現在的老婆(道地的台灣人)就把LA的診所關了. 台灣真不錯啊 2個孩子可以學到地的國語 台灣話. 美國醫療也快截體了 40%所得稅 超高的醫師保險費. 不忙還真付不起龐大的開業成本. 計畫在待台灣10年. 等孩子學好中文可能再次移民美國. 以我這個美國醫師的角度看台灣醫療. 覺得每一個 醫師都在做公德. 台灣人民真該謝謝這群默默奉獻自己的台灣醫界.[/quote]

您說得沒錯 是備逼著做公德