what mental health problems/risks does this patient have?

[kcvo]

sam is experiencing multiple mental health issues. what are the 3 major problems or potential risks in the case study ???

i'm thinking depression,sucide and mania.but i'm not sure i'm on the right track.can anyone have a look?

case study

sam is a 42 years old male who was brought into the mental health unit by the police under section 22, after he physically threatened to hit his boss at work for firing him. for the last several months, sam has been showing up late for work, unable to complete his allocated duties, has been involved in verbal altercations with his workmates and was observed to sneak in alcohol and drink it at lunchtime. his boss warned him to seek help for his problems otherwise he will lose his job; however, sam always denied having a drinking problem and eventually was fired from work. on admission, sam was irritable, argumentative, with slurred speech, poor judgment and his breath smelled of alcohol. sam admits to consuming 3-4 drinks of alcohol every night when he comes back from his work. he states, "it relaxes me and makes me feel good". he has been drinking heavily for the last 2 weeks, almost half a bottle of whisky every night after his wife and children left him. in the past, his wife threatened to take the children and leave him if he did not stop drinking, but she did not leave because she felt obliged to keep the family together. however, two weeks ago, she could not cope anymore and decided to leave. she was scared for the safety of herself and children due to sam's increased incidence of anger outbursts and physical threats. whilst taking sam's family history, he stated "i'm like dad, we both love alcohol and there is nothing wrong in that". upon further assessment, sam reveals to you that his father used to shout and yell at him and he witnessed his father bashing his mother when he was drunk. sam reported that he had a poor relationship with his father as a child, he always felt insecure, threatened and scared. he grew up with constant worry, feelings of worthlessness, fear and guilt. sam revealed to you that he drinks alcohol to help him forget about his painful past and to cope with the stress he was having at work. he also tells you that "i have been drinking heavily lately because i miss my wife and kids and i feel lonely and bored with my life". whilst conducting a risk assessment, sam expressed feelings of guilt, hopelessness and despair. he tells you "i am a failure and no good for anyone...i lost my wife, my kids and my job...i wish i was dead".

[CuriousMe]

Have you considered alcoholism?

[kcvo]

I know he has alcohol abuse disorder,but is this considered a mental health problem as well?

[CuriousMe]

In what other body system would you classify addiction?

[wetzoo]

Yes, Alcoholism is a mental illness.

Also depression and risk for suicide

[Mandychelle79, ASN, RN]

Ineffective denial r/t alcoholism

Risk for injury r/t alcohol withdrawl

risk for injury r/t angry outbursts

[~Mi Vida Loca~RN, ASN, RN]

I don't see Mania in there at all. Suicide and depression are 2 I could see but not mania. People with Bi-Polar that usually have the mania and than the severe lows, in the mania phase they are basically over excited. They usually don't think they even need medication because they feel so good and who doesn't like to feel extremely happy? (well some people loathe happiness) but anyway. They can also have outbursts and rage and irritation, but that is usually stemmed from the mental disorder itself, where as in this case, I would be willing to bet his outbursts are more related to the alcohol and other mental issues going on.

If you look at it from an addiction stand point, think of mania as more associated with cocaine and meth. Speed type drugs.

[~Mi Vida Loca~RN, ASN, RN]

He is also at risk for harming others AEB the outbursts on his boss and co workers and the threats.

[diane227, LPN, RN]

The first priority would be the fact that this guy may go into alcohol withdrawal. Second would be depression, potential for harm to self/ others.

[diane227, LPN, RN]

Also, reference the DSM for information on how to formulate a diagnosis, Axis 1-5.

[cmonkey]

Ineffective denial r/t alcoholism

Risk for injury r/t alcohol withdrawl

risk for injury r/t angry outbursts

Is there a dx for effective denial?

[kcvo]

Thx all of ur advices.What about ineffective coping related to alcohol abuse?