CASE REPORT PRESENTATION

__________________ DISORDER
 Substance Induced Mood Disorder
 Substance-induced disorders include various disorders in which substance induced mood disorder is also being
included. Substance-induced disorders are distinct from independent co-occurring mental disorders in that all or
most of the psychiatric symptoms are the direct result of substance use. A client might even have both
independent and substance-induced mental disorders. Depression may be caused or precipitated by the use or
abuse of substances such as drugs, alcohol, medications, or exposure to toxins (Whiteford, 2013).

 A mental health professional or physician must determine whether the mood disorder occurs as a result of the
substance or just happens to occur at the same time by coincidence. If it develops as a result of the use of or
exposure to the substance then this diagnosis may be appropriate. To make a diagnosis of a substance-induced
mood disorder, the disturbance can only occur while a person is intoxicated or going through withdrawal (Wang
et al., 2007).
 Case Report

 Setting:
 Case was taken from Rawal Hospital Khanapul Islamabad.
 Demographic Details:
 Name S.K
 Age 30
 Gender Male
 Marital status Married
 Education Intermediate
 Occupation Overseas worker
 No. of siblings 6
 Birth order Last
 Dependent /Independent Independent
 Religion Islam
 Presenting complaints

 Explain verbally
 History of Present Illness

Client reported that six years before he started consuming cannabis because of friends. He tried several

time to quite its consumption but failed. According to him he only consumed the drug when he came back

to Pakistan while during his stay at abroad he never used it. He stayed at job for a month continuously

and got holidays of 30 days afterwards. So for those thirty days he didn’t take the drug but from last year

he became short tempered and started fighting on very minute matters. He was unable to control his

anger. He has become hyper and resistant to his current behavior.

Past Personal History

Client reported that his birth was normal and there were no complications in birth

and all childhood milestones were achieved at the proper age. He reached the puberty

at 17 years of age and got informal awareness about sexual relationship. Client also

reported that he never had extra marital relationships.

Family History

Client reported that he belongs to upper middle class. His father was authoritative

figure in family and family structure was nuclear. His all brothers were independent and he

himself was independent for past six to seven years.

 Pre-Morbid Personality

Client reported that he had lots of friends and had extrovert personality. He

always enjoyed trips and parties with friends. He never fought with his

family members and friends before. He had controlled personality. He

reported that his nature was sensitive and he was never been irritable and

selfish. He never had anger management and mood swings problem before.
 Mental Status Examination:

Results of mental state examination revealed that client was attentive, alert, cooperative and a little

aggressive. Eye contact was appropriate. The client was well-groomed and neatly dressed. He was

confident and at ease in verbal communication. His intellectual level was slightly average. His

memory functions were intact as he memorizes the past event. Thought content revealed no indication

of delusions, paranoia and suicidal ideation. There was no evidence of perceptual disorder and his

level of insight appeared to be good.

 Formal Assessment

The client was formally assessed with the following tests

 House Tree Person (HTP)

 Thematic Apperception Test(TAT)

 Rotter’s Incomplete sentence blank.( RISB)

 Raven Standard Progressive Matrices (SPM)

 Bender Gestalt Test (BGT)

 YMRS (Young’s Mania Rating Scale)

 MMPI (Minnesota Multiphasic Personality Inventory)

Diagnosis

Substance induced mood disorder.

 Theoretical Orientation

Substance abuse is very common problem now a days. According to Freud,

personality consists of three components: the id, superego, and ego. The id is

instinctive, impulsive, and childlike. It wants immediate satisfaction of needs, urges, and

cravings. In the case of drugs, the id craves drug. The superego is sometimes thought of as

the parent or conscience. It is the moral component of the personality. The superego knows

"right" from "wrong" and its function is to control the impulses of the id (Degenhardt., 2013).

Finally, the ego is similar to the adult and it mediates the id and superego (Wang et al., 2007).
No. of Sessions

 Total 7 sessions were conducted to gather the information from the client
 Therapist/ client orientation Dynamics

 No issues of transference and counter transference happened in the

whole process of psychotherapy.
Termination

 After achieving the psychotherapeutic goals set up by the client and therapist,

therapy was decided to be terminated. During the last session the therapist checked

the progress of the therapy. Client told the therapist that he has learned a lot and he is

regulating his thoughts and behavior. His symptoms were getting low in frequency.