Assessing And Diagnosing Patients With Mood Disorders
Assessing And Diagnosing Patients With Mood Disorders
Accurately diagnosing depressive disorders can be challenging given their periodic and, at times, cyclic nature. Some of these disorders occur in response to stressors and, depending on the cultural history of the client, may affect their decision to seek treatment. Bipolar disorders can also be difficult to properly diagnose. While clients with a bipolar or related disorder will likely have to contend with the disorder indefinitely, many find that the use of medication and evidence-based treatments have favorable outcomes.
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To 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. Assessing And Diagnosing Patients With Mood Disorders
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.).Week 3: Mood DisordersTraining Title 2
Name: Ms. Julie Houston
Gender: female
Age:19 years old
T 98.1 P-78 R-18 119/74 Ht 5’2” Wt 184lbs
Background: Recently started a business undergraduate program in Boston, MA after growing
up and living in South Carolina her whole life. Grew up with both parents, two brothers, and
one sister. Currently lives in off-campus housing with two other female roommates. Currently a
full-time student, not employed. Not married, currently single. She has no previous psychiatric
history; takes no medications. There is no psychiatric or substance use history for her or family.
No legal hx NKDA
Symptom Media. (Producer). (2016). Training title 2 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-2
Training Title 8
Name: Mrs. Leslie Tilman
Gender: female
Age: 32 years old
T- 97.6 P- 97 R 22 149/98 Ht 5’3 Wt 245lbs
Background: Recently had her first child two months ago. Currently married; stay at home
mother after working in retail for 5 years. Grew up with both parents, one sister in Omaha, NE. Assessing And Diagnosing Patients With Mood Disorders
Completed education through bachelor’s level, studying physics. Previous employment included
research science as well as high school substitute teaching for 5 years prior to birth. No
previous suicidal gestures has uncle who committed suicide via GSW. She denied
drugs/alcohol; uncle was opioid abuser. Hx of HTN-prescribed labetalol 100mg twice daily,
admits to missing doses due to forgetting. No legal hx. Allergies: codeine
Symptom Media. (Producer). (2016). Training title 8 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-8
Training Title 18
Name: Ms. Ashley Domingo
Gender: female
Age:20 years old
T-97.9 P-68 R-18 118/82 Ht 5’1 Wt 120lbs
Background: Currently living off-base in California, active duty in the Army, MOS 92M Mortuary
Affairs Specialist. Grew up in Houston, 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; NKDA
Symptom Media. (Producer). (2017). Training title 18 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-18
Training Title 28
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.ezp.waldenulibrary.org/watch/training-title-28
Training Title 38
(Same patient in video 43 but presentation of his illness pre-hospitalization)
Name: Mr. Will Loman
Gender: male
Age:19 years old
T- 98.6 P- 94 R 24 128/78 Ht 5’7 Wt 152lbs
Background: Currently lives with his sister and two parents in Jacksonville, FL. Not currently
employed. Completed high school, not currently in school. Hx of treatment for mood disorder
began age 15, previous trials of Depakote, Olanzapine off and on, side effects of wt. gain. Has
hx of a three-day hospitalization one year ago after found wandering on the side of the
freeway, but he signed himself out ‘against medical advice.’ 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 2–3 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 trespassing as a juvenile. Has pending court
date for indecent exposure. Allergies: PCN
Symptom Media. (Producer). (2016). Training title 38 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-38
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Training Title 43
(Same patient in video 38 but presentation of his illness with hospital treatment)
Name: Mr. Will Loman
Gender: male
Age:19 years old
T- 98.2 P- 74 R 18 120/70 Ht 5’7 Wt 156lbs
Background: Currently lives with his sister and two parents in Jacksonville, FL. Not currently
employed. Completed high school, not currently in school. Hx of treatment for mood disorder
began age 15, previous trials of Depakote, Olanzapine off and on, side effects of wt. gain. Has
hx of a three-day hospitalization one year ago after found wandering on the side of the
freeway, but he signed himself out ‘against medical advice.’ 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. 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. Father has history of bipolar
disorder. No history of self-harm behaviors, no family suicides. Mother reports he has slept 2–3
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; hospital admission labs within normal ranges, UDS negative; Hx of trespassing as a juvenile.
Has pending court date for indecent exposure. Allergies PCN
Symptom Media. (Producer). (2016). Training title 43 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-43. Assessing And Diagnosing Patients With Mood Disorders
Training Title 150
Name: Ms. Liliana Ball
Gender: female
Age:16 years old
T- 97.4 P- 84 R 18 134/88 Ht 5’3 Wt 118lbs
Background: Currently living with her parents in Tacoma, WA along with two young siblings. She
is a sophomore in high school, not currently partnered, reports she is bisexual, lately having lot
of unprotected sex that her parents don’t know about. She has been stealing money out of her
mom’s purse to buy clothes, makeup, “and just other things.” She has history of treatment
since age 7 for conduct disorder, depression, history of taking sertraline which worsened her
irritability, aggression, impulsivity. She has been in a 3-month teen residential mental health
facility discharged one month ago with lithium 300mg in am and 600mg at bedtime,
aripiprazole 10mg 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 crush my
creative art.” She has hx of domestic violence toward her mother and 2 younger sisters as
juvenile. No current legal issues. Her grandmother has hx of bipolar disorder, her mother and
her maternal aunt have anxiety. She is sleeping 3–4hrs/24 hrs. Reports her appetite “is great.”
She has no medical issues; has Nexplanon implant; hx of self-harm with cutting.
Symptom Media. (Producer). (2018). Training title 150 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-150
Training Title 118
Name: Mr. Oscar Luna
Gender: male
Age: 52 years old
T- 98.6 P- 90 R 24 140/84 Ht 5’8 Wt 170lbs
Background: Born and raised in Leopold, IN. 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
as a dishwasher. Enjoys playing music. He has long hx of mental health treatment since age 14.
Previous medication trials include lithium (toxicity), Depakote (wt gain), aripiprazole (akathisia),
risperidone (dystonia), haloperidol (didn’t give a fair trial), quetiapine (wt gain), reports in past
helpful medication was lurasidone, lamotrigine, olanzapine but states “they really squash my
creative song writing though.” Poor historian. Never married, reports he is 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 1–3 drinks of alcohol when “playing music in the clubs”, denied illicit drugs,
has history of overdose at age 28, history of 3 inpatient psychiatric hospitalization, most recent
was 1 year ago. Allergies: doxycycline; hx of rosacea.
Symptom Media. (Producer). (2018). Training title 118 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-118
Training Title 144
Name: Ms. Amy Hartford
Gender: female
Age: 32 years old
T- 98.2 P- 74 R 18 120/70 Ht 5’1 Wt 150lbs
Background: Currently lives in Phoenix, AZ, divorced with two children ages 10 and 8. Born and
raised in Tucson, AZ with her mother and four sisters NKDA: no legal hx
Symptom Media. (Producer). (2018). Training title 144 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-144. Assessing And Diagnosing Patients With Mood Disorders
