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Depressiondisorder.docx

Concept Map Template

Primary Diagnosis: ____________________Depression_______________________________________

1. Describe the pathophysiology of the primary diagnosis in your own words. What are the patient’s risk factors for this diagnosis?

Pathophysiology of Primary Diagnosis

Major depressive disorder is a mood disorder whose hallmark is a persistent feeling of sadness. The pathophysiology of depression is linked to an imbalance of neurotransmitters in the brain (Boland & Verduin, 2021). The acceptable model for describing the pathophysiology of depression is a deficiency of monoamine neurotransmitters particularly norepinephrine and serotonin in the central nervous system (Filatova et al., 2021). The reduction in these neurohormones produces the characteristic syndrome of depressive symptoms.

Causes

Risk Factors (genetic/ethnic/physical)

1. Deficiency of monoamine neurotransmitters (Filatova et al., 2021)

2. Family and genetics

3. A decrease in neuroendocrine factors like brain-derived neurotropic factor (BDNF)

4. Psychological factors such as life events and environmental stresses

5. Certain medications like anticonvulsants, beta blockers, opioids, statins, and anticholinergic drugs (Boland & Verduin, 2021)

a. Family history of depression

b. Female gender

c. Chronic daily stress

d. Low socio-economic status

e. Chronic medical illness

f. Being single or divorced

(Boland & Verduin, 2021)

2. What are the patient’s signs and symptoms for this diagnosis? How does the diagnosis impact other body systems and what are the possible complications?

Signs and Symptoms – Common presentation

How does the diagnosis impact each body system? Complications?

1. Depressed mood

2. Loss of interest or pleasure in most or all activities

3. Decrease or increase in appetite or weight

4. Anxiety

5. Trouble concentrating

6. Trouble sleeping characterized by early morning awakening

7. Fatigue

8. Suicidal ideation

(Boland & Verduin, 2021)

a. Coronary artery disease

b. Diabetes mellitus

c. Osteoporosis

d. Anxiety disorders

e. Substance use disorder (Boland & Verduin, 2021)

3. What are other potential diagnosis that present in a similar way to this diagnosis (differentials)?

1. Bipolar mood disorder with mixed episodes (Boland & Verduin, 2021)

2. Medication-induced major depressive disorder

3. Hypothyroidism

4. Stroke

5. Multiple sclerosis

6. Attention-deficit hyperactivity disorder (ADHD)

4. What diagnostic tests or labs would you order to rule out the differentials for this patient or confirm the primary diagnosis?

1. Complete blood count with differentials to rule out infectious diseases

2. Thyroid function tests to rule out hypothyroidism

3. Blood glucose test to rule out hypoglycemia

4. Liver function tests to rule out alcohol-induced depression

5. HIV test to rule out HIV-encephalitis

6. Head Computerized tomography scan (CT scan) to rule out head injury and space occupying lesions.

6. What treatment options would you consider? Include possible referrals and medications.

1. Treatments

Pharmacological Therapy

Antidepressants like:

a. Selective serotonin reuptake inhibitors (Strawn et al., 2022)

b. Tricyclic antidepressants

c. Serotonin-norepinephrine reuptake inhibitors

Non-pharmacological therapy

a. Cognitive behavioral therapy (Strawn et al., 2022)

b. Interpersonal therapy

2. Referrals

a. Psychiatrist

b. Psychologist

References

Boland, R., & Verduin, M. (2021). Kaplan & Sadock's Concise Textbook of Clinical Psychiatry.

Filatova, E. V., Shadrina, M. I., & Slominsky, P. A. (2021). Major depression: one brain, one disease, one set of intertwined processes.  Cells,  10(6), 1283. https://doi.org/10.3390/cells10061283

Strawn, J. R., Mills, J. A., Suresh, V., Peris, T. S., Walkup, J. T., & Croarkin, P. E. (2022). Combining selective serotonin reuptake inhibitors and cognitive behavioral therapy in youth with depression and anxiety.  Journal of affective disorders,  298, 292-300. https://doi.org/10.1016/j.jad.2021.10.047