Lawrence1

C&P results Diagonsis #1 Schrizophrenia ,residual type. Axis #1 Diagonis #2 Depressive Disorder NOS Axis #1 Axis #2 No evidence of any Axis II personality order,or substance abuse. Axis #3 medical diagnoses no TBI see medical chart. Axis #4 Psychosocial and Eviromental Problems [ Wife with MH problems bipolar, minor problems at work for absenteeism [ sick days and FMLA time , Sons legal issues. FMLA is for Wifes bipolar. Axis #5GAF of 53. Does the vet have more than one mental disorder dx ?[Y] Is it possible to differentiate what symptom is/are attributable to each dx,[Y] Schizophrenianresidual type- paranoia, affective flattening, minor disorganization of speech/thought. Depressive Disorder NOS- mixed anxiety/depression, frequent tearfullness, anhedonia ,lower libido. Occupational and social impairment in most areas [ 70%] Is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder ? [ N]. Differentiation would be speculative. Symptoms; Depressed mood [Y] Suspiciousness [Y] Flattened affect [Y] Speech intermittently illogical, obscure, or irrelevent; Remarks; Cooperative,open . SPEECH;Coherent,halting at times, verbose/rambling. MOOD;mild dysphoria. AFFECT; flattened; HALLUCINATIONS; denied; THOUGHT PROCESS; Grossly Logical, but some minor disorganization observed. Pt endorsed paranoid thoughts about coworkers and supervisors; Suicidial thoughts denied; ORIENTED X4; MEMORY; recenr/remote intact. ATTENTION. poor to fair. Pt easily distractid and needs redirection. JUDGMENT; poor to fair; INSIGHT; poor to fair; Regarding dx; the veteran meets DSM-IV for a continuing dx of Schizophrenia, residual type, as paranoiac delusions, affective blunting, and some disorganization of thought still persist. In contrast to his most recent tx providers [ who GAF scores indicated mild-moderate severity].,this exminer opines that the condition is of moderate severity in its negative impact on social/familial and occupational functioning for this veteran The Veteran also meets criteria for Depressive Disorder NOS [mixed anxiety/depression], that per review of his old discharge records indicate claim of depression, is at least as likely as nt secondary to his Schizophrenia. Mood disorders often accompany psychosies, often in reaction to the social/career devastation psychotic disorders render. While the veterans mental illness surely causes significant diddiculties with work and family life, and he has little to no unproblematic social support, he is not currently judged to be unemployable based solely on his psychiatric status. DONE I have held a job at a warehouse for 15 years,its not easy foe me. Years ago I was committed against my will into the Va psych ward three different times.So I learnedto stay out of trouble away from most people and keep out of the hospital That method worked until I developed prostate problems and went to the VA for help..I lasted about 4 years of Primary Care only until late 2010 and then I started getting depressed. All of 2011 kept getting worse so I told my Primary Care doctor about my depression and my having a history of MH issues.She dx me with depression and ask me to get a full MH assessment.The assessment was that I had depression/anxiety and needed meds and therapist . All of 2012 ihave been going to the MH doctor and therapist and I am on Sertraline 50mg tab 1/2 each night also 1/2 tab od .25 mg of resperdol to take the edges off at least the nurse describes it that way I am wondering about the C&P results ? And somewhat worried the disolving the edges can lead to me getting into trouble again.

C&P results Diagonsis: #1: Schrizophrenia, residual type Axis {1} Diagnosis #2:Depressive Disorder NOS Axis {1} Axis IV- Psychosocial and enviormental Problems:Wife with bi-polar MH problems,minor dicipline at work fro absenteeism { sick leave and FMLA time} Axis#5 GAF score of 53. Does Vet have more than one MH disorder diagnosed ? {X}Yes Is it possible to differentiate? {Yes} Schrizophrenia- paranoia, affective flattening, minor disorganization of thought. Depressive Disorder NOS mixed anxiety/depression, frequent tearfullness, anhedonia, lower libido. TBI {No} {X} Occupational and social impairment in most areas.Symptoms: Suspiciousness, Depressed Mood, Flattened affect, Speech intermittently illogical, obscure, or irrelvent.CURRENT MENTAL STATUS; Cooperative- open,SPEECH; Coherent,halting at times, verbose/rambling.MOOD; mild dysphoria AFFECT; flattened HALLUCINATIONS' none; thought process;grossly logical, some disorganization observed. PT endorsed paranoid thoughts; SUICIDAL THOUGHTS; denied.ORIENTED:x4. MEMORY;remote/intact.ATTENTION;poor to fair; JUDGEMENT;poor to fair; INSIGHT; poor to fair. REGARDING DX; the veteran meets DSM-IV criteria for a continuing dx of Schrizophrenia,Residual type,as paranoiac delusions,affective blunting,and disorganization of thought/speech still persist. In contrast to his most recent tx providers [whose GAFS indicated mild-moderate severity ] this examiner opines that the condition is of moderate severity in its negative impact on social/familial and occupational functioning for this veteran. The veteran also meets criteria for Depressive Disorder NOS [ mixed anxiety/depression] that per review of his records [including a discharge note indicating claim of depression ] is at least as likely as not secondary to his schizophrenia. Mood disorders i\often accompany psychoses, often in reaction to the social/career devastation psychotic disorders render..There is no evidence of any Axis II personality disorder, pr of any current DSM_IV substance abuse/dependence. While the veteran,s mental illness surely causes significant difficulities with work and family life, and he has little to no unproblematic social support, he is not currently judged to be unemployable based solely on his psychiatric status. I have held a job at a warehouse for the last 15 years.I kept away fron the VA MH system because of the 3 involuntary commitments for MH years ago.I have been going to the VA for about 4 years for Primary Care for prostate problems.MY PC doctor was unaware of my older MH problems so I left well enough alone until last year 2011. I stsrted getting depressed lare 2010 and got worse all of 2011 so in Jan oa 2012 I told my PC doctor about my depression She sent me to get an evaluation and it showed i NEEDED psy care and meds. Iam on 1/2 of 50mg of sertraline once a day , also 1/2 of .25 once a day of risperdol [ to take the edge off ] as the nurse says. I have wondering if I am on enough meds.ALso I wonder what results the C&P wil have on my ratings.

I have a SC of 50% for schrizophrenia and recently had to ask my PC provider an the VA for help with depression.The doctor sent me for evaluation and I was dx with a secondary problem of anxiety/depression.I had a P&C in October of 2012 and have a copy of it. I am seeing a med adjusting nurse and a therapist every other month for the last year .The meds are risperdone 1/2 of a .25 pill once a day and sertaline 1/2 of 50mg tab once daily.The meds cause different problems,the meds seem to fight depression for me except the meds take away some of the barriers that I have always been able to control.I have applied for a higher disability because of the anxiety/depression getting too much control of me last year.I would like to discuss the C&P results and any of the problems listed in it.