Advanced Psychopharmacology

Bipolar Case Study Transcript

Chief Complaint: Mrs. Sylvia Contesta is a 62-year-old Hispanic female with complaint of “sometimes I hear people talking about me and they stare.” Patient is accompanied by her oldest daughter to the visit.

History of Present Illness:

Onset: For the past 2 months, patient has been up all night cleaning because she cannot sleep.

Location: Headaches on occasion.

Duration: Past 2 months.

Characteristics: Daughter reports that her mother is constantly cleaning out and reorganizing drawers and closets and is “throwing out things stating she no longer needs them.” The daughter notes that most things are not trash or unwanted, so she finds this behavior odd.

Patient reports that she is “not tired” even without sleep and “has a lot to do to welcome festivities for her granddaughter’s new baby arrival next year.” The daughter reports that none of the grandchildren are “having babies.”

The daughter is worried about her mother’s drastic change of behavior and attitude, which is becoming more tearful, irritable, and angry when they try to stop her from all the cleaning and organizing.

Aggravating: Increased symptoms with decreased sleeping.

Relieving: Rest can be distracted from family visits, but sleep is helpful when not distracted.

Temporal: Worse on weekends when she has fewer visitors.

Severity: I just don’t sleep sometimes but my family is bothered by my cleaning. I just want everything neat and complete for upcoming events.