What disorder/s does she have?
Extracted text: 100% A hospital-based psychiatric consulta- tion-liaison service was called to assess possible depression in Rebecca Ehrlich, a 24-year-old woman who had been hos- pitalized 2 days earlier for severe ab- dominal pain. She had been admitted through the emergency room for the lat- est flare-up of her underlying Crohn's disease. The consultation was called af- ter the nurses became concerned that she was sad and lonely and was having a difficult time adjusting to her medical condition. cine or nursing and asked the student how he had decided to go to medical school. Ms. Ehrlich said that she had previ- ously worked regularly and had "quite a few friends" but that the recurrent ab- dominal pain had wrecked her social life and her job prospects. She had lost a job before because of absenteeism the year and had missed several job interviews due to her Crohn's flares. She had dated as a teenager but had been single since college. These things "were not the end of the world, but how would you feel?" As a member of an online bowel dis- Ms. Ehrlich was interviewed by the medical student on the psychiatry ser- vice. The patient indicated that the pain was excruciating and that she was nei- ther sad nor lonely but was simply visit- ing from out of town, so no one knew she was even in the hospital. She told the medical student that her only previ- ous therapy had been in college, when she went to student health services to orders support group, Ms. Ehrlich e- mailed other members on a daily basis. She added that the only person in the family who "got" her was an aunt who also had Crohn's disease. The primary medical team was hav- ing difficulty obtaining collateral infor- mation from previous physicians, but the medical student was able to contact Ms. Ehrlich's mother. She did not know the exact names or phone numbers of her daughter's medical providers but did recall some of the hospitals and could recall, approximately, some of the physicians' names. She added that her daughter had not wanted her to be in- volved in her care and had not told her get help for anxiety about test taking and her career choice. She had success- fully completed a short course of cogni- tive-behavioral therapy, and the anxiety had not reappeared. She denied any other psychiatric history and had never taken psychiatric medication. In college, she studied psychology and worked part-time as a hospital orderly Ms. Eh- rlich had considered a career in medi she was out of town, mnuch less that she 70°F Clear 27
Extracted text: ws in the hospital She dld any that the Crohn's disease hud been dixgnosed 2 years carlier. during her daughter's last semester of college. The mother esH- mated that Ms. Bhrtich had been hoepi- tallzed at least abx times, in.contrast with the daughter's report af two earlier hos- pitalizations. Neither the gastrointesti- nal (GI) team nor the medical student was able to locate Ms. EhrtHch's primary gastroenterologist, whose name the pa- tient could only spell phonetically. On examination, Ms. Ehrlich was co- operative and conversant, and appeared comfortable. Her speech was fluent. She appeared calm and unworried about her upcoming procedures. Her thought pro- cess was linear. She denied paranoia, hallucinations, or suicidality. Attention and both recent and remote memory were intact. She acknowledged that it had been difficult living with Crohn's disease, but she was optimistic that her symptoms would improve. She denied depressive symptoms. She looked sad at the beginning of the interview, but she appeared more engaged and euthymic the more she talked. She could not ex- plain why the team was unable to Jocate her doctor and became irritated when the medical student pressed more spe cifically to elicit further details about her prior care. She was takern to have an en doscupy and a colonoscopy at the end of the interview. tbld the student that she was "feeling better atready." She quickly remaved her awn inbravengus line and started to get dreesed. The student went to get the primary Gl team When they returned, the patlent was gone. The medical student spent nmuch of the next day calling hoapltals and physi dans that met descriptions provided by the patient and her mother. That after- noon, one of the physiciang called back and Indicated that he had treated Ma. Ehrlich 6 months earlier at a hospital near her mother's home. That admission was strikingly similar. after a short hos- pitalization, she quickly fled from the hospital after a normal colonoscopy. Ms. Ehrlich's endeseopy and colonoe copy resulis were normal That evening, the medical student from psychialry sal in with the Gtearm as they reviezed the normal resuliS with the patent.She said she was relirved there vvoKJolonger anything senously wrong with her The Gl team tolN-her that sE Could be dN charged the ex merring nd trat sbe should have her interrie dee She readily agreed Arterthe CIeam lete M. Edcle