Week (4) Comprehensive psychiatric evaluation
Jharana khadka
College of Nursing-PMHNP, Walden University
PRAC 6645: Psychopathology and Diagnostic Reasoning
Dr. Suhad Sadik
12/18/2025
, PRAC 6645 Comprehensive Psychiatric Evaluation Template
Subjective:
CC (chief complaint): I feel broken, empty inside.
HPI: D.B. is a 52-year-old Black male who presents for psychotherapeutic evaluation due to
long-standing emotional emptiness and relational stressors. He is not currently prescribed any
psychotropic medications. He presents accompanied by his wife in the assessment due to
concerns related to mood, emotional detachment, anger, and family conflict.
The patient reports that his symptoms are long-lasting and that their onset is unclear. He
states that he experienced emotions during middle school, but noted that by high school, he felt
emotionally numb. He reports having had a few close friends during childhood, but has not
maintained close relationships as an adult. He describes himself as feeling “broken inside” and
reports limited access to emotions, stating that anger and irritation are the primary emotions he
can identify. He recalls experiencing fear when his two older children were born, but otherwise
describes emotional detachment. The patient additionally stated that sexual activity is the only
experience that brings him a sense of pleasure or happiness, noting that other activities do not
evoke enjoyment or emotional connection. He denies compulsive sexual behavior but reports
reliance on sex as his primary source of emotional relief.
The patient reports increasing distress after his wife informed him that his interactions
with their children are perceived as mentally abusive, particularly due to his tone and
condescending communication style. He reports intentionally withdrawing from family
interactions, stating, “I don’t want to hurt anyone.” He reports poor sleep due to rumination (“I
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