Mood Disorders
Review this week’s Learning Resources. Consider the insights they provide about assessing and diagnosing mood disorders.
Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Identify at least three possible differential diagnoses for the patient.
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
Reading Requirements:
American Psychiatric Association. (2013). Bipolar and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm03
American Psychiatric Association. (2013). Depressive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
Chapter 8, Mood Disorders
Chapter 31, Child Psychiatry (Section 31.12 only)
MedEasy. (2017). Mood disorders (depression, mania/bipolar, everything in between) | USMLE & COMLEX [Video]. YouTube. https://www(dot)youtube(dot)com/watch?v=59umGpQyaHs
Case History Reports:
Name: Mrs. Louise Carson
Gender: female
Age: 49 years old
T- 98.8 P- 99 R 20 150/88 Ht 5’5 Wt 135lbs
Background: Currently living in Indianapolis, IN, working full-time as a logistics buyer in a
medical facility. Has an MBA. Lives with her husband and three children, three boys who are all
teenagers. Born and raised in Indianapolis, IN with her mother and two sisters. Father deceased
in MVA when she was 2 years old. Sister has depression; mother has history of being a
“functioning alcoholic”. Recently informed by her PCP she has a “fatty liver.” Allergies: latex
Symptom Media. (Producer). (2016). Training title 28 [Video]. https://video-alexanderstreetcom(dot)ezp(dot)waldenulibrary(dot)org/watch/training-title-28
Title
Your Name
Subject and Section
Professor’s Name
Date
Subjective:
CC (chief complaint): “My husband told me that I am usually not speaking and feeling down for the past few months, but I have not told him that I have been having suicidal thoughts lately.”
LC is a 49-year-old Caucasian female with a family of five, consisting of a husband, and three teenage boys. She complains that she has been feeling down for the past 6 months and started to have suicidal thoughts 3 months ago. She lost interest in her hobbies and seldom goes out with her friends. She claims that she cannot fully concentrate at work or have a good night’s sleep for the past two months.
Past Psychiatric History:
* General Statement: The client stated that she did not feel this way last year, but the symptoms started six months ago.
* Caregivers (if applicable): The client has a husband and three teenager boys. Other possible caregivers are her mother and two sisters.
* Hospitalizations: none
* Medication trials: none
* Psychotherapy or Previous Psychiatric Diagnosis: None
Substance Current Use and History: (+) alcoholic-beverage drinker (2 bottles of beer a week), non-smoker, and no history of illicit drug use.
Family Psychiatric/Substance Use History: The mother was a functional alcoholic and one of the sisters has depression.
Psychosocial History: LC grew up with her mother and two sisters in Indianapolis. Her father died of motor vehicular accident when she was two years-old. She graduated with an MBA and is currently working full-time as a logistics buyer in a medical facility. The job requires her to travel around cities to find and negotiate with the best suppliers and she also personally inspects the products. This gave her increased levels of stress due to the high workload as she works from Mondays to Fridays. She currently resides with her husband and three children in a townhouse in Indianapolis. She enjoys playing sports, singing, and hanging out with friends. She does not have a hx of any legal issues and no convictions.
Medical History:
* Current Medications: None
* Allergies: Latex
* Diagnosed Diseases: Fatty Liver Disease
* Reproductive Hx: OB Score G3P3 (3-0-0-3). The patient has an irregular menstrual cycle (28 to 60 days) that lasts for 3 to 5 days; pads are fully soaked and changes pads thrice daily. According to her OB-Gyne, she is about to menopause.
* ROS:
* GENERAL: alert, coherent, cooperative; knows and tracks her change in mood
* HEENT: Hair is equally distributed, vision is 20/20 in both eyes, no visual problems, no ear infections or hearing problems, nostrils are patent and clear, no cavities or oral infections
* SKIN: no lesions, open wounds, rashes, and scars; denies pain or injury, persistent itching, or unexplained perspiration
* CARDIOVASCULAR: no high blood pressure, no rapid and irregular heartbeats
* RESPIRATORY: no cough, wheezing, difficulty of breathing
* GASTROINTESTINAL: no abdominal pain or tenderness, nausea, vomiting, hematemesis, and hematochezia
* GENITOURINARY: no increase in frequency, urgency, blood in urine, dysuria; denies incontinence
* NEUROLOGICAL: no weakness in limbs, no slurred speech, denies altered sensations and confusion, numbness
* MUSCULOSKELETAL: no muscle pains, arthritis, gout; the normal range of motion and muscle strength
* HEMATOLOGIC: no sudden bleeding in any part of the body, blood transfusions, hepatitis, IV drug use
* LYMPHATICS: no lymphadenopathies and lymphadenitis
* ENDOCRINOLOGIC: denies changes in eating and drinking behavior, changes in sensorium, easy fatigability, and changes in temperature perception.
Objective:
Physical exam: LC is well-developed, well-nourished, ectomorph, oriented x 3 (place, person, time). She appears exhausted, stressed, and has a low mood, not in cardiorespiratory distress.
Vital Signs:
* Temp: 98.8 deg F
* PR: 99 bpm
* RR: 20 cpm
* BP: 150/88 mmHg
Anthropometric:
* Ht: 5’5”
* Wt: 135 lbs
* BMI: 22.5 kg/m2 (normal)
HEENT: Head: Equal hair distribution, no infestations, no tenderness on the frontal and maxillary sinuses. Eyes: Eyes are symmetri...