Friday, October 13, 2017

File: 5/02/2016 Paranoid, delusions, aliens, anxiety, balcony

[PDOC] 05/02/2016

F31.2: Bipolar disorder, current episode manic severe with psychotic features (Active as of 10/16/2015)

F29: Unspecified psychosis not due to a substance or known physiological conditioner (Active as of 11/21/2013)

F31.9: Bipolar disorder, unspecified (Active as of 10/29/2014)

F39: Unspecified mood [affective] disorder (Rule Out as of 11/21/2013)

4/20/15: Clt's current symptoms and presentation and symptoms are congruent with previous diagnosis.

11/21/13: Client reports paranoid thinking with delusions. (Thinking people are aliens and endorsing a hx [history] of beliefs that she can fly and that she will not die for long if she kills herself.) Client reports a hx of auditory and visual hallucinations, but none at the moment. Client reports anxiety related to personal relationships. Clients reports that she tried to overdose to kill herself last night with plans to do so again.

10/08/13:. Pt presents as preoccupied, possibly responding to internal stimuli, hears voices telling her to stab herself, reports some improvement in psychotic symptoms.

10/1/13: Client presents "ramped up" with thoughts of jumping into traffic or "Flying off her balcony" w/o specific intent of suicide. She is calm in presentation but she reports that she has felt increasingly "ramped up" over the last 2 weeks. She spoke with her psychiatrist this morning and she recommended she resent to PES. [Psych. Emergency Services]

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