A 25-year-old male presents to your clinic because he is having difficulty his new job

Clinical Summary: The patient is a 25-year-old male who is seeking medical attention due to difficulties at his new job. He works at a consulting firm and reports difficulties in giving presentations due to fear of embarrassment and low self-esteem. As a result, he has declined several opportunities for promotion. He does not have difficulty interacting with peers in small groups or in non-work settings.

Problem List:

1. Difficulty giving presentations at work
2. Fear of embarrassment and low self-esteem
3. Declined opportunities for promotion

Diagnosis: A possible diagnosis to consider is Social Anxiety Disorder (SAD).

Rationale: The patient’s symptoms of fear and embarrassment in social situations, specifically in the work setting, are consistent with the diagnostic criteria for SAD. Additionally, the fact that he does not have difficulty interacting with peers in other settings suggests that his symptoms are specific to the work environment.

Differential Diagnosis: Other diagnoses to consider include:

1. Generalized Anxiety Disorder (GAD)
2. Adjustment Disorder with Anxiety
3. Major Depressive Disorder (MDD) with anxiety features.

Screening Tools:

1. The Patient Health Questionnaire (PHQ-9)
2. The Generalized Anxiety Disorder 7 (GAD-7) scale
3. The Mini-International Neuropsychiatric Interview (MINI)

Treatment: A comprehensive treatment plan should be developed to address the patient’s symptoms and improve his functioning. Psychotherapy, such as cognitive-behavioral therapy (CBT) or exposure therapy, is the first-line treatment for SAD. Psychopharmacology, such as selective serotonin reuptake inhibitors (SSRIs), can also be considered as an adjunctive treatment. Psychoeducation about SAD and its treatment can also be beneficial.

Standard Guidelines:

1. The American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
2. The World Health Organization’s (WHO) International Classification of Diseases (ICD-11)
3. The National Institute for Health and Care Excellence (NICE) guidelines for the treatment of anxiety disorders.

ANSWER SUMMARY

A 25-year-old male presents to your clinic because he is having difficulty his new job. He works at a consulting firm. He states it is hard for him to give presentations due to concerns that he will embarrass himself and his peers will think less of him. To avoid being put on the spot, he has passed up multiple lead roles and potential promotion as a result. He says this is frustrating because he doesn’t have an issue interacting with peers in small groups or friends and in no work settings.

• Summarize the clinical case.
• Create a list of the patient’s problems and prioritize them.
• Which diagnosis should be considered
• What is your rationale for the diagnosis
• What differential diagnosis should be considered
• What test or screening tools should be considered to help identify the correct diagnosis
• What treatment would you prescribe and what is the rationale (consider psychopharmacology, diagnostics tests, referrals, psychotherapy, psychoeducation)
• What standard guidelines would you use to assess or treat this patient

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

Submission Instructions

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 evidence-based sources.