MENTAL STATUS EXAM:
The patient is a mildly
overweight, white male, wearing blue jeans and a
shirt. He was also wearing a makeshift necklace that has
a large plastic medallion in the shape of a Pokeman [sic] characters [sic] head. He also had a number of “shrinky dink” decorations attached to this necklace. He had a large backpack that he carried with him and had a
notebook containing a large number of drawings. He showed the examiner an extensive set of
trading cards, which he created for his video game characters. The artwork was hand drawn and then scanned into the
computer for transfer to the card. He had a number of statistics and other information on the backside of the card. The patient pointed out a series of cards that were of a video game theme, but depicted him in various difficult situations in which he has dealt with recently. He also presented the examiner with his
business card containing a link to
his website. His speech was somewhat nasal with frequent, awkward laughing during his sentences. His speech was fluent. His responses were appropriate to the questions posed to him. Overall, the volume of his speech was slightly elevated, although his tone was generally pleasant and almost jovial. His thought processes were linear and logical. He was somewhat concrete, especially regarding social interactions. He seemed to have good insight into his limitations. As suggested above, his thought content was largely based on his interest in Pokeman [
sic] and sonic [
sic] cartoons. He did not express any delusional thought content. There was perhaps an obsessional quality to
his preoccupation with finding a girlfriend, although he did not feel that this was a problem for him. He did not voice any perceptual disturbances and did not seem to be responding to internal stimuli. His impulse control appeared to be good during the interview and his judgment was fair, although social judgment was likely somewhat limited.
Folstein score was 30/30 with his sentence being, “
Uncle Spunky is a really funky monkey.”
IMPRESSION:
Mr. Chandler is a 22-year-old man with a history of developmental delays and autism. D
espite these limitations, he seems to have been quite successful in maximizing his academic abilities. Despite his significant delays in language, he has over the years developed relatively affective [sic] communication skills. He is left, however, with a severe degree of social awkwardness and seems to have good insight into this. He is left feeling somewhat frustrated as he has a strong desire for companionship, although his social limitations prevent him from being able to realize this in the way which he would like. He has been on antidepressants for many years and it is not entirely clear what role they played. As mentioned above, there is a certain obsessional quality to his thoughts, although it is not clear that he meets criteria for an obsessive-compulsive disorder. Overall, he has a sense that the Paxil has been
affective [
sic] in tempering his frustrations and anger. His parents also feel he has benefited from it. He would possibly benefit from psychotherapy, although this would need to be tailored to his interpersonal style. Ideally this would be done in a setting tailored to patients with this sort of developmental problem. Based on the information available at this time, the patient doesn't seem to pose a significant threat to himself or anyone else. There is some suggestion that the anger control has been a problem, although how that has manifested itself is unclearly [
sic].
He certainly has no history of physical violence which would suggest any future risk.