Mental health articles

tourette syndrome case study report Case 1
A 25-year-old mother of a 2-month-old infant is frantic because he seems to ignore
her and her husband when they talk to him. She tells the psychiatric nurse
that she is afraid that her son is mentally retarded and blames herself, saying that
she must have done something wrong during her pregnancy. She tells the psychiatric
nurse that she definitely knows her son is mentally retarded because her
sister’s daughter acted the same way and she was diagnosed with mental retardation.
She is heartbroken and does not know what to do.
Question 1. Why should the mother be concerned?
Answer: The infant should turn his head toward sounds by 2 months of age. The
mother’s concerns are justified because the infant does not respond to the voices
of both parents.
Question 2. What information should the psychiatric nurse gather from the parent?
Answer: Does the infant coo, pay attention to faces, and follow people and
things with his eyes? Can the infant hold up his head and make smooth movements
with his arms and legs? These are all important milestones of a healthy 2-month-old infant.
Question 3. What might be the reason for the infant’s lack of response to sound?
Answer: This could be an early sign of autistic disorder and mental retardation.
However, the infant’s presentation is also compatible with a hearing disorder, especially
if the infant displays many of the 2-month-old milestones.
Case 2
A 53-year-old grandfather is frustrated that his 11-year-old granddaughter was
diagnosed with major depression disorder (MDD). He tells the psychiatric nurse
that she is lazy and her parents play into her manipulation. The grandfather says
he tells his granddaughter to get out of her moodiness and face reality. He reports
always saying to her, “Pick yourself up, dust yourself off, and start over again if
things get you down,” which is a line from his favorite song. He thinks the doctor is
too quick to put kids on medication.

Question 1. What might be the rationale for the grandfather’s opinion?
Answer: The grandfather, like many of us, has experienced periods of depression
that last for a relatively short period of time after which his mood returns
to normal. The grandfather assumes that clinical depression is the same as what
he experienced. The grandfather also realizes that 11-year-olds sometimes manipulate
parents to avoid activities that they dislike. The grandfather assumes his
granddaughter is being manipulative.
Question 2. What are the faults in the grandfather’s rationale?
Answer: Researchers believe that clinical depression is caused by a chemical imbalance
with neurotransmitters. A person diagnosed with clinical depression such
as MDD cannot return to a normal range of emotions without administration of
medication that returns balance to the neurotransmitter. Yes, 11-year-olds can be
manipulative; however, a psychiatrist assessed the child and diagnosed the child
as having MDD. In doing so, the psychiatrist has probably ruled out other causes
of the child’s behavior.
Question 3. What should the psychiatric nurse suggest the grandfather do in
this situation?
Answer: The psychiatric nurse should provide a brief explanation of MDD and
how this differs from situational depressions that the grandfather occasionally
experiences. The psychiatric nurse should also encourage the grandfather to ask
his granddaughter’s parents if he could attend the next family meeting with the
psychiatrist so he can learn more about his granddaughter’s condition.

Tags: tourette syndrome