CC (chief complaint): “I am depressed”
HPI:
The patient is a 24-year-old male who has voluntarily admitted inpatient and transitioned
to the Copper Springs partial hospitalization program (PHP). During the assessment, the patient
was referred to the facility on 05/26/2023 for depression and endorsed SI with a plan to hang
himself with his hammock as well as for alcohol detox. He states he had been drinking for 5 days
and he was not drinking before that for a couple of weeks. He denied detox symptoms and stated
his most severe symptoms are related to depressed mood. He stated that he has been hearing
auditory hallucinations which are none commanding. This was his first visit to the facility. The
patient endorsed a recent increase in symptoms of depression.
Depression endorsed with symptoms: He described anergia. Anger and angry episodes
had been occurring. Anhedonia is described by the patient. The difficulty of concentrating was
described. The patient reported excessive fatigue. The patient reported having feelings of guilt
and feelings of hopelessness. Symptoms of irritability were present. The patient denied
obsessive, intrusive, and persistent thoughts or compulsive, ritualistic acts. The patient
specifically denied manic symptoms.
Substance Current Use:
Patient denies current and past substance abuse/use. The patient has a history of alcohol
use/abuse last use 05/26/2023
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