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Case Class #6: Justin

- **Age:** 50 years
- **Marital Status:** Married
- **Education:** High School
- **Employment:** School Bus Driver and Security Guard

**Background:**
- Described by his wife and family as hard-working, disciplined, with a strong character.
- Has never suffered psychotic symptoms, nor has a psychological, psychiatric, or substance use history.
- Reported history of physical and psychological abuse towards his wife.

**Incident:**
- One month before being admitted to the hospital, Justin had a car accident resulting in a serious Traumatic Brain Injury (TBI) after running out of brakes while driving.
- Required intubation and treatment in an Intensive Care Unit (ICU).

**Post-Accident Behavior:**
- After being discharged, Justin began presenting anxiety and irritability, has become extremely aggressive, and alleges that "his wife is sleeping with other men."
- A family friend suggests his wife take him to the ER.

**ER Evaluation Results:**
- **Mental State:** Collaborative, friendly, and fluent in language.
- **Thought Content:** "My wife has many lovers and they are robbing me... if I see them, I am going to kill them." Observed delusions of jealousy and lack of awareness of his deficits.
- **Affect:** Variable, between euthymic and irritable when talking about his wife.
- **Mini Mental State Exam (MMSE):** 27/30, with errors in immediate and short-term memory.
- **MRI Results:** Revealed encephalomalacia in the bilateral frontal lobes, orbitofrontal cortex (predominantly right), and right frontal contusion as a result of the TBI.

**Question:**
Now, Justin has just been referred to you in the ER to decide the best course of action. Answer briefly:

1) Do you think he would benefit from psychiatric/pharmacological treatment? Yes or no, and why?

Answer :

Final answer:

Justin, with his symptoms of increased aggression, delusions, and jealousy following a Traumatic Brain Injury (TBI) Treatment, could likely benefit from both psychiatric and pharmacological interventions. Management of Frontal Lobe Syndrome involves medications and psychotherapy. Additionally, anger management and domestic violence intervention programs might be needed due to his history of abuse.

Explanation:

Yes, Justin would likely benefit from psychiatric and pharmacological treatment. The traumatic brain injury (TBI) he suffered in the car accident may have resulted in behavioural and emotional changes. The MRI showed encephalomalacia (softening of the brain tissues) in the bilateral frontal lobes and cortex, areas of the brain responsible for emotional control and social behaviour. The increased aggression, delusions, and jealousy may be symptomatic of Frontal Lobe Syndrome, which can be managed with both pharmacological and psychological interventions.

Pharmacological treatment, including medications like mood stabilizers or antipsychotics, can help manage his symptoms. Concurrently, psychotherapy can provide strategies to manage his emotions and improve social interactions. Also, considering his history of abusing his wife, anger management and domestic violence intervention programs might be beneficial.

Learn more about Traumatic Brain Injury (TBI) Treatment here:

https://brainly.com/question/33914738

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