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SP2 presentation 2013

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by

Louise Roper

on 30 July 2013

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Transcript of SP2 presentation 2013

Case Presentation: 'Ben'
Louise Roper 0998746

Past Medical History
History of Presenting Complaint
Significant side effects of treatment
Not able to see friends
Extreme boredom leading to negative thinking
Non-compliant with medication
Suicidal ideation aged 15 years
Family history, personal and situation
Father has history of mental illness
Nuclear family
Good set of friends
Deprived area
Good school attendance and conduct until illness
Ben's niece and nephew are fostered by his parents and live in the family home
Mental State Examination
Ben
17 year old male
Diagnosed with ALL at 14 years
Admitted to BCH for treatment immediately and treated successfully over past 3 years
Presenting complaint: Low mood
Diagnosed with ALL at 14 years
Treated over 3 years at BCH
Treatment caused many adverse side effects. eg: 4-5L of diarrhoea per day
Hospitalised for periods of up to 5 months at a time.
Quarentined due to illness and immunosuppression
Nephrectomy aged 7 years
No additional drug history
Past psychiatric history
None
1. Appearance and Behaviour
Appearance:
Very thin.
Clean clothes, appropriate for his age and background

Behaviour:
Avoidant. Did not want to make eye-contact. Looked at the floor if asked a difficult question.

Quiet, not forthcoming with information.

2. Speech
Tone, volume, rate were reduced

No evidence of formal thought disorder
3. Mood and Effect
Mood
Subjective: Fine
Objective: Low
Affect
Labile and suspicious
4. Disorders of thought content
Negative cognitions and ruminations
Suicidal thoughts, plans, intent.
5. Perception
No disorders evident
6. Cognition
Problems with attention and concentration
7. Insight
Saw psychologist once. Did not like her and refused to see her again
Psychological Effects of Disease and Treatment in Adolescents with Acute Lymphoblastic Leukaemia
Possible Interventions
Insight - Realise that there is a problem
Deal with negative cognition
Cognitive Behavioural Therapy
Acceptance
Coping strategies
Full transcript