ASSESSING AND DIAGNOSING PATIENTS WITH MOOD DISORDERS
ngoregina1
PRAC6635WEEK3Assignment.docxTO PREPARE:
· 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.
BY DAY 7 OF WEEK 3
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-TR 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.).
DIFFERENT VIDEO CASE STUDIES (SELECT ONE)
Select one of the following videos to use for your Assignment this week. Then, access the document “Case History Reports” and review the additional data about the patient in the specific video number you selected.
· Symptom Media. (Producer). (2016). Training title 2 Links to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-2
· Symptom Media. (Producer). (2016). Training title 8 Links to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-8
· Symptom Media. (Producer). (2017). Training title 18 Links to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-18
· Symptom Media. (Producer). (2016). Training title 28 Links to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-28
· Symptom Media. (Producer). (2016). Training title 38 Links to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-38
· Symptom Media. (Producer). (2016). Training title 43 Links to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-43
· Symptom Media. (Producer). (2018). Training title 118 Links to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-118
· Symptom Media. (Producer). (2018). Training title 144 Links to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-144
· Symptom Media. (Producer). (2018). Training title 150 Links to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-150
Use these case histories to supplement the information about the patients in the video case studies.
Week 3: Mood Disorders
Training Title 2 Name: Ms. Natalie Crew Gender: female Age:17 years old T 97.4 P-82 R-1 20 128/84 Ht 5’2” Wt 192lbs
Background: Recently started an accelerated high school business program in Chicago, Illinois after growing up and living in New Orleans her whole life. Grew up with both parents and four brothers. Currently lives in on a specialty high school campus dormitory. Currently a full-time student and works part time in the local coffee shop. Not married, currently single. She has no previous psychiatric history; takes no medications. There is history of depression, denied substance use history for her or family. No legal hx NKDA Symptom Media. (Producer). (2016). Training title 2 [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa tch/training-title-2
Training Title 8 Name: Mrs. Abrianna Tilman Gender: female Age: 27 years old T- 98.6 P- 88 R 18 154/92 Ht 5’1 Wt 230lbs Background: Recently had her first child two months ago. Currently married; stay at home mother after working in community library for 5 years. Grew up with her mother after her parents divorced when she was 16; has two sisters in Troy, Alabama. Completed education through bachelor’s level, majoring in English Literature. No previous suicidal gestures. Brother committed suicide via GSW. She denied drugs/alcohol; brother was addicted to methamphetamines. Hx of HTN-prescribed Trandate 100mg twice daily, admits to missing doses due to forgetting. No legal hx. Allergies: PCN Symptom Media. (Producer). (2016). Training title 8 [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa tch/training-title-8
Training Title 18 Name: Ms. Rosario Campbell Gender: female Age:25 years old T-97.7 P-70 R-18 118/72 Ht 5’3 Wt 123lbs Background: Currently living off-base in El Paso, Texas, active duty in the Army, MOS 92M Mortuary Affairs Specialist. Grew up in McAllen TX with both parents and one brother.
Completed education through high school. Currently partnered. No children. Mother history of depression; brother hx of cannabis use. No medical history. No legal hx; allergy: cipro previous medication trials: sertraline, fluoxetine both with good effects when taking. Symptom Media. (Producer). (2017). Training title 18 [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa tch/training-title-18
Training Title 28 Name: Mrs. Ada Carson Gender: female Age: 54 years old T- 97.6 P- 94 R 22 162/84 Ht 5’5 Wt 144lbs Background: Currently living in Sioux Falls, South Dakota, working full-time as a contract negotiator in a financial company. Has an MBA. Lives with her husband and two teenage twin sons. Born and raised in Trenton, NJ, with her father and two brothers, her mother deceased when she in MVA when she was 12 years old. Brother has depression; mother has history of being a “functioning alcoholic”. Recently informed by her PCP she has a “fatty liver.” Allergies: codeine Symptom Media. (Producer). (2016). Training title 28 [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa tch/training-title-28
Training Title 38 Name: Mr. Elijah Loman Gender: male Age:18 years old T- 98.3 P- 93 R 22 118/68 Ht 5’7 Wt 149lbs Background: Currently lives with his sister and two parents in Durham, NC. Not currently employed. Completed high school, not currently in school. Hx of treatment for mood disorder began age 15, previous trials of risperidone, quetiapine off and on, side effects of wt. gain. Has hx of a six-day hospitalization one year ago after found wandering at night in the mall parking lot without clothes. He refused medication due to previous experiences. Not currently partnered. He has been sexually inappropriate with comments to female neighbors; pulled his pants down in the mall. Denies any recent alcohol or substance use. Father has history of bipolar disorder. No history of self-harm behaviors, no family suicides. Mother reports he has slept 4-5 hours in past week, up spending money buying and playing new video games and says he is writing a book on how others can be a video game master. Appetite is decreased. No medical hx; Hx of vandalism as a juvenile. Has pending court date for indecent exposure. Allergies: latex
Symptom Media. (Producer). (2016). Training title 38 [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa tch/training-title-38
Training Title 43 Name: Mr. Elijah Loman Gender: male Age:20 years old T- 97.2 P- 84 R 18 118/68 Ht 5’7 Wt 156lbs Background: Currently lives with his sister and her husband who are his legal guardians as parents deceased when he was 15 and he was deemed to need a fiduciary and guardian by the court system. Not currently employed. Completed high school, not currently in school. Hx of treatment for mood disorder began age 15, previous trials of Depakote, Quetiapine off and on, side effects of akathisia. Has hx of a multiple hospitalization, last was 4 months ago when he exposed his genitals to girls at the mall. . Not currently partnered. He is currently in hospital admitted one week ago, was initiated on lithium 300mg po three times daily and risperidone 1mg at bedtime. Denies any recent alcohol or substance use. Paternal uncle has history of bipolar disorder. No history of self-harm behaviors, no family suicides. Appetite is decreased. No medical hx; hospital admission labs within normal ranges, UDS negative; Hx of truancy as a juvenile. Has pending court date for indecent exposure. Allergies NKDA Symptom Media. (Producer). (2016). Training title 43 [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa tch/training-title-43
Training Title 150 Name: Ms. Cheyenne Lisenbe Gender: female Age:18 years old T- 97.4 P- 94 R 22 136/86 Ht 5’2 Wt 121 Background: Currently living with her parents in Locust Grove, Oklahoma along with two younger sisters and 1 older brother. She is a senior in high school, not currently partnered, reports she is bisexual, lately hyper-sexual reporting increase of unprotected sex. She has been stealing money out of her grandmother’s purse to buy clothes, shoes, purses, “and just other things. She has history of treatment since age 9 for conduct disorder, depression, history of taking citalopram which worsened her irritability, aggression, impulsivity. She has been in a 90- day teen residential mental health facility discharged three months ago with lithium 300mg in am and 600mg at bedtime, aripiprazole 2.5mg in the morning. When discharged, her labs were within normal ranges and urine toxicology negative. She was positive for cannabis upon admission. Her parents believe she is hiding her medication as she has made comments “they slow me down; they make me not think fast” She has hx of domestic violence toward her older brother with juvenile assault charge. No current legal issues. Her grandmother has hx of bipolar
disorder; her mother and her maternal aunt have anxiety. She is sleeping 2-3hrs/24 hrs. Reports her appetite “ravishing.” She has no medical issues; has Nexplanon implant; hx of self-harm with cutting, last engaged in the behavior 6 months ago. Symptom Media. (Producer). (2018). Training title 150 [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa tch/training-title-150
Training Title 118 Name: Mr. Connor Walsh Gender: male Age: 57 years old T- 97.2 P- 94 R 20 156/88 Ht 5’8 Wt 163lbs Background: Born and raised in Peru Indiana Is staying at a shelter after being homeless in MacArthur Park for 1 year in Los Angeles. He lost his apartment and his job working part-time at Home Depot. Enjoys playing music. He has long hx of mental health treatment since age 19. Previous medication trials include lithium (was effective), Depakote (gastric upset), aripiprazole (akathisia), risperidone (hyperprolactinemia), haloperidol (dystonia), quetiapine (didn't give a fair trial), Poor historian. divorced once, reports being gay, no children; estranged from only living sister, parents deceased. He is not sure of his family mental health or substance use history but feels like he is most like his aunt, she has history of mental health treatment “but I’m not sure for what.” States that he got a master’s degree in music theory at Stanford. Admits to 3-6 drinks of alcohol when “playing music in the clubs”, denied illicit drugs, has history of intentional drug overdose at age 22, history of 8 inpatient psychiatric hospitalization, most recent was 8 months ago. hx of one detox admission 15 years ago Allergies: bee stings Symptom Media. (Producer). (2018). Training title 118 [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa tch/training-title-118
Training Title 144 Name: Ms. Amy Hartford Gender: female Age: 26 years old T- 98.2 P- 70 R 18 128/76 Ht 5’0 Wt 152lbs Background: Currently lives in Scottsdale, AZ, divorced with two children a daughter age 8 and son age 4. Born and raised in Mesa, AZ with her mother and two sisters Works as paralegal, has an associate degree; no legal hx; allergic to dicyclomine; history of rosacea
