A 19-year-old woman is brought to the emergency department after intentionally ingesting ten 500-mg acetaminophen tablets following a recent breakup. She is medically stabilized, and her acetaminophen levels remain well below the treatment threshold. During the psychiatric evaluation, she is tearful and states she feels 'completely empty inside' and hates being alone. She describes a history of intense, short-lived relationships and frequently changing her college major because she 'does not know who she is.' When the physician explains that she will be discharged with a psychiatric outpatient follow-up appointment, she becomes suddenly enraged, yelling, 'You doctors do not care about anyone!' Moments later, she apologizes profusely and begs the physician not to abandon her. She reports that under extreme stress, she sometimes feels like she is detached from her body. Which of the following statements regarding this patient's diagnosis and management are accurate? (Select all that apply)
- Dialectical behavior therapy is considered a first-line, evidence-based psychotherapeutic intervention for her condition.Cevap
- BHer transient, stress-related dissociative symptoms indicate an underlying diagnosis of schizophreniform disorder.
- CThe physician should breach confidentiality to notify the patient's ex-boyfriend of her presentation.
- Establishing and consistently maintaining clear physician-patient boundaries is an essential component of her clinical care.Cevap
- EThe initiation of a selective serotonin reuptake inhibitor as monotherapy is contraindicated due to a high risk of precipitating mania.