Prepare a case profile of anxiety disorder person.
बहिर्मुखी व्यक्तित्व वाले व्यक्ति का एक वृत्त विवरण तैयार करें
Prepare a case profile of extrovert personality.
समूह-ब / Group-B
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Answer any one question
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Answer:
Abstract:
The exact cause of Generalized Anxiety Disorder is not fully understood. The current hypothesis is that neurotransmitters including serotonin, dopamine, and norepinephrine levels fluctuate, causing patients psychological state to change. The patient in the case study reported many clinical symptoms that can be misinterpreted for musculoskeletal deficits. Physical therapy cannot directly cure anxiety, since it is thought to be caused by neurotransmitters within the brain. However, physical therapists can help those who suffer from GAD be aware of their anxiety. The purpose of this case report is to report how physical therapy can’t cure GAD; however it can help reduce physical signs and symptoms associated with GAD.
Introduction:
Generalized Anxiety Disorder affects 3.1% of the U.S population. GAD is characterized by constant and excessive worrying, for at least six months or more. GAD can be considered a primary or secondary disorder, depending on the time of onset. Diagnosis at a young age is considered a primary disorder, and secondary is normally diagnosed later in life and is associated with other disorders. GAD is most often associated with other disorders that involve anxiety and depression and can lead to or worsen pre-existing conditions. Many of the bodies systems can be affected by GAD, including: Cardiopulmonary, Musculoskeletal, Gastrointestinal and Neurological systems. This disorder can manifest in several ways, incorporating physical, behavioral, and cognitive characteristics.
Case Presentation:
A 28 year-old Caucasian female presents to the clinic with complaints of joint pain (arthralgia) and intermittent low back pain. Patient cannot recall any mechanism of injury. She reports she has trouble falling asleep at night and is unable to get a good night’s rest. She often feels "restless" or "on edge", which she associates with not sleeping. She states she constantly worries about her performance in school, her family, and her mother’s health, who has recently been diagnosed with Stage IV Small Cell Carcinoma. Patient also states she wakes up at night with throbbing headaches that last for a couple hours. She feels tense the majority of the day, causing her to feel stiff. She also has difficulty paying attention in class and finishing her homework.
Subjective:
Joint pain, low back pain, headache, muscle stiffness, difficulty sleeping and paying attention for approximately a year. Previously diagnosed with PTSD and treated with CBT.
Demographic Information: Second Year Graduate Student, female, 28
Medical diagnosis if applicable: Diagnosed with PTSD in February of 2000.
Co-morbidities:
Hypertension, drinks 10+ alcoholic beverages per week (possible substance abuse), Depression
Previous care or treatment: PTSD treated with Cognitive Behavioral Therapy by Clinical Psychologist following car crash in 2000.
Self-Report Outcome Measures:
GAD-7 = 16/21, Penn State Worry Questionnaire (PSWQ) = 64/80, McGill Pain Questionnaire = 42/78
Physical Performance Measures:Oswestry Disability Index (ODI) = 38%
Objective:
Vitals: HR= 98 bpm (tachycardia), BP: 146/92 mmHg (hypertension), RR= 24 bpm. Palpable muscle tightness in upper trapezius, forward flexed head along with increased kyphosis. Patient appears to be profusely sweating and hands are cold and clammy to touch.
• Cervical AROM= limited extension and bilateral rotation
• Shoulder AROM= bilateral shoulder flexion decreased.
• All other shoulder AROM WFL.
• Myotomes= C1/C2, C2/C3 and C3/C4 weakness
• UE sensation intact
• LE AROM= limited trunk flexion/extension, along with knee flexion and ankle dorsiflexion deficits.
• Myotomes= L4/L5, L5/S1 weakness
• LE sensation intact
Clinical Impression:
¬ Hypertension
¬ Tachycardia
¬ Increased respiratory rate
¬ Red Flags:
Patient used phrases such as “restless and on edge” to describe her current state.
Patient has a significant medical history and suffered from PTSD and possible substance abuse, along with the stress of school and her mother’s health.
¬ Outcome Measures: Patient scored significantly high on the GAD-7, Penn State Worry Questionnaire & the McGill Pain Questionnaire.