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What Does The Following Mental Health Assessment Report Indicate?
Question: My son was given a recent mental health assessment and I do not understand what the M.D. wrote. Please do see the written assessment this M.D. wrote. Please do explain this to me in layman’s terms and easy for me to understand what this assessment is saying. My son currently has VA benefits for mental health and I wanted to know if this assessment was in his favor, to still continue in receiving the VA beneftis.
“Assessment: This is a difficult patient on many levels. His history suggest a strong component of exaggerated sxs. It is curious that he sxs have so significantly worsened over the years. Veteran is cot cooperative either. Again, he presents as a characiture of a paranoid person. (Alost as a parody.) The fact is that he is not functional. I do not see any signs of psychosis. He does have a history of childhood trauma, separation from mother during formative years. One might expect some infantile personality organization. He has a history of childhood depression and of chronic depression. He is service connected for PTSD. His presentation is quite dramatic. Prognosis is very poor. There is no therapeutic alliance. Veteran’s motivation for changes is unclear.
Plan: med management: increase his quetiapine and restart bupropion.”
“Assessment: This is a difficult patient on many levels. His history suggest a strong component of exaggerated sxs. It is curious that he sxs have so significantly worsened over the years. Veteran is cot cooperative either. Again, he presents as a characiture of a paranoid person. (Alost as a parody.) The fact is that he is not functional. I do not see any signs of psychosis. He does have a history of childhood trauma, separation from mother during formative years. One might expect some infantile personality organization. He has a history of childhood depression and of chronic depression. He is service connected for PTSD. His presentation is quite dramatic. Prognosis is very poor. There is no therapeutic alliance. Veteran’s motivation for changes is unclear.
Plan: med management: increase his quetiapine and restart bupropion.”
Brief Answer:
It is not in your favor
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read his assessment will try to explain in layman terms.
The doctor says that he is difficult patient and there is minimal chance he will improve to significant level (poor prognosis). The M.D. also mentions that many of his symptoms are in exaggerated form which means his symptoms are not present to the extent he describes. He is of the opinion that despite this your son is not co-operative for treatment and that's why he is losing hope for further improvement.
He is not able to understand motive behind the exaggerated symptoms that's why he uses word curious.
He is also of the opinion that he is not suffering with psychosis although he mentions that he has past history of psychiatric disorder like childhood depression and long term depression.
So to conclude that his M.D considers him as a made up case rather than a real problem.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
It is not in your favor
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read his assessment will try to explain in layman terms.
The doctor says that he is difficult patient and there is minimal chance he will improve to significant level (poor prognosis). The M.D. also mentions that many of his symptoms are in exaggerated form which means his symptoms are not present to the extent he describes. He is of the opinion that despite this your son is not co-operative for treatment and that's why he is losing hope for further improvement.
He is not able to understand motive behind the exaggerated symptoms that's why he uses word curious.
He is also of the opinion that he is not suffering with psychosis although he mentions that he has past history of psychiatric disorder like childhood depression and long term depression.
So to conclude that his M.D considers him as a made up case rather than a real problem.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Why then did M.D. ordered quetiapine and bupropion? Is it common practice for Dr. to order meds even if Dr. opinion is that this is a made up case rather than a real problem?
Why did M.D. in the assessment said "The fact is that he is not functional." What does this mean?
Why did M.D. in the assessment said "The fact is that he is not functional." What does this mean?
Brief Answer:
Probably he wanted to do something
Detailed Answer:
Hello,
Thanks for reverting back to me.
There is two meaning can be inferred from this statement. But the most likely it means that patient is not able to take care of himself or not able to do that he is expected to do as per his age and health. This commonly happens in majority of individuals who have heavy component of dramatization. They do not engage in any work to make others believe that they are really suffering.
I do not think there is any role of particular drugs but in betterment of patient sometime doctor prescribe off label medication. There is also possibility that his M.D. was not sure about his diagnosis and he prescribed for something which he was suspecting but that was not obvious in shadow of made up symptoms.
I do not recommend you to challenge as it is more likely to worsen the problem for your son. In most of the made up symptoms becoming more sympathetic to the patient makes things worse over the long run. In my view it is better if you can follow his instructions and ask your son to do the same. As per available assessment it will be in best interest of the patient.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
Probably he wanted to do something
Detailed Answer:
Hello,
Thanks for reverting back to me.
There is two meaning can be inferred from this statement. But the most likely it means that patient is not able to take care of himself or not able to do that he is expected to do as per his age and health. This commonly happens in majority of individuals who have heavy component of dramatization. They do not engage in any work to make others believe that they are really suffering.
I do not think there is any role of particular drugs but in betterment of patient sometime doctor prescribe off label medication. There is also possibility that his M.D. was not sure about his diagnosis and he prescribed for something which he was suspecting but that was not obvious in shadow of made up symptoms.
I do not recommend you to challenge as it is more likely to worsen the problem for your son. In most of the made up symptoms becoming more sympathetic to the patient makes things worse over the long run. In my view it is better if you can follow his instructions and ask your son to do the same. As per available assessment it will be in best interest of the patient.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Worsen the problem? He stays in his room all day. Has no friends, has many nightmares and can not sleep. Some days he sleeps all day. He was raped in the Navy and suffers from PTSD and depression. I do not think your review is correct. This assessment has to be disputed. Also, my son is suffering with over 80% of psoriasis and joint pain as well. He always touches and scratches himself to address the burning pain he has all over his body. So his actions by scratching himself profusely can give off the impression that he is exaggerating and move about the chair or room, standing up and setting down, can not stay still during mental health exam – this is what I think? Is this correct of my thinking? If so, then we do need to challenge this assessment.
Brief Answer:
you seem to be right
Detailed Answer:
Hello,
Thanks for reverting back to me.
I have given my opinion on basis of available information and I may be wrong as I do not have full acecess to his medical and psychiatric history.
With the latest information I feel you are right in saying that you should challenge the opinion. You can discuss all concerned in his care including psychiatrist, dermatologist and psychologist and talk to his M.D about your inference of his assessment.
I hope this clears the situation for you.
Thanks and regards
you seem to be right
Detailed Answer:
Hello,
Thanks for reverting back to me.
I have given my opinion on basis of available information and I may be wrong as I do not have full acecess to his medical and psychiatric history.
With the latest information I feel you are right in saying that you should challenge the opinion. You can discuss all concerned in his care including psychiatrist, dermatologist and psychologist and talk to his M.D about your inference of his assessment.
I hope this clears the situation for you.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you for your new clarification with the new information provided by me. Can you please tell me what are your credentials, where are you located at? How many years of practicing do you have in the field. Are you board certified? And where? Please do reply back to me as soon as you can. Once I have this requested information I will close the discussion session with you. Thank you very kindly for your time and attention in this matter.
Brief Answer:
yes I am board certified
Detailed Answer:
Hell,
Welcome back to me.
You can check all needed information under my profile.
I am M.D psychiatry with D.M in geriatric Mental Health.
Currently I am practising in XXXXXXX and have experience of 14 years.
I am board certified in my country of practice.
I hope I am able to answer you to the level of your satisfaction.
If you have more queries feel free to write directly to me using url that i provided earlier.
Thanks and regards
Dr Ashok Kumar
yes I am board certified
Detailed Answer:
Hell,
Welcome back to me.
You can check all needed information under my profile.
I am M.D psychiatry with D.M in geriatric Mental Health.
Currently I am practising in XXXXXXX and have experience of 14 years.
I am board certified in my country of practice.
I hope I am able to answer you to the level of your satisfaction.
If you have more queries feel free to write directly to me using url that i provided earlier.
Thanks and regards
Dr Ashok Kumar
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
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