10-26-2006, 04:29 PM
A 49-year-old patient is evaluated for suicidal ideation after he is found laying on train
tracks by police. The man is disheveled and malodorous and states that he has "reached
the end" and would rather die. He admits to depressed mood, anhedonia, poor energy and
appetite; he feels miserable and regrets what he has done with his life and wants to put an
end to it. He states he has felt this way since age 26, after he was discharged from the
military. The man indicates that his life was "great" until he increased his drinking, which
caused a divorce at age 30. He has had two arrests for driving under the influence. He
was in jail for 6 months after he had an accident while drunk that resulted in public
property damage. He remembers that he initially felt sick in jail, with sweating, vomiting,
shaking, and he experienced a seizure. He then improved after a few days and felt better
during the rest of his imprisonment without any depression. Which of the following
criteria most strongly suggests alcohol abuse?
A. Desire to cut down
B. Recurrent drunk driving
C. Seizure after withdrawal
D. Suicidal ideation
E. Tolerance
tracks by police. The man is disheveled and malodorous and states that he has "reached
the end" and would rather die. He admits to depressed mood, anhedonia, poor energy and
appetite; he feels miserable and regrets what he has done with his life and wants to put an
end to it. He states he has felt this way since age 26, after he was discharged from the
military. The man indicates that his life was "great" until he increased his drinking, which
caused a divorce at age 30. He has had two arrests for driving under the influence. He
was in jail for 6 months after he had an accident while drunk that resulted in public
property damage. He remembers that he initially felt sick in jail, with sweating, vomiting,
shaking, and he experienced a seizure. He then improved after a few days and felt better
during the rest of his imprisonment without any depression. Which of the following
criteria most strongly suggests alcohol abuse?
A. Desire to cut down
B. Recurrent drunk driving
C. Seizure after withdrawal
D. Suicidal ideation
E. Tolerance