Axis I diagnosis to consider in this patient

  Case Study: For most of his life, Bert had been called a “worry wart.” Three months ago, he took a position as an administrative assistant and reports to six vice-presidents. Each one expects Bert to follow through on his requests immediately. Bert worries that he is not doing a good job and will not be recommended for promotion. He feels tired all the time and has trouble concentrating at work. He also worries about the possibility of illnesses in his family, property tax increases, and terrorist attacks. He has trouble falling asleep at night although he feels exhausted. He is irritable at home and yells at his children without reason. He is slightly overweight, appears apprehensive, and is restless. His speech is clear, coherent, relevant, and spontaneous. He denies having obsessions, compulsions, phobias, delusions, or hallucinations. He continues to enjoy watching sports on TV but he is worried about his relationship with his wife and children. His brother-in-law has encouraged him to use alcohol to relax in the evening. • What Axis I diagnosis would you be likely to consider in this patient? • What model of psychotherapy would you consider? • Would you consider pharmacologic intervention? If so, what? • What treatment outcomes and changes in this patient would you expect to see?