Assignment Assessing and Diagnosing Patients With Mood Disorders

Assignment Assessing and Diagnosing Patients With Mood Disorders

Assignment Assessing and Diagnosing Patients With Mood Disorders

Psychiatric Assessment Sample Paper

Mood disorders are some of the commonest psychiatric disorders. The commonly witnessed mood disorders include major depression, dysthymic disorder, bipolar disorder, substance induced mood disorder and mood disorder resulting from a generalized medical condition. Commonest symptoms observed in individuals with mood disorders include irritable state, persistent sadness and anxious states, changes in both feeding habits and weight, alteration in the sleep pattern and difficulty concentrating on various tasks (McElroy, Guerdjikova, & Romo-Nava, 2021 Assignment Assessing and Diagnosing Patients With Mood Disorders).

Mood disorders can be observed in individuals of all age groups. It is, however, difficult to diagnose mood disorders in children as they have a harder time expressing their thoughts and feelings. In this paper, I shall analyse a clinical scenario, provide my differential diagnosis and state what I would do different if I were to assess the patient again.

Patient’s information.

Ms. Julie Houston is a 19-year-old female patient who recently started a business undergraduate program in Boston, MA after growing up and living in South Carolina for majority of her life. She has grown up with both parents, two brothers and a sister. She currently lives in a housing unit outside campus with two other female roommates. She is currently a full-time student who is unemployed. She is currently not on any medication and has no psychiatric history. There is no history of psychiatric illness or substance use among her family. She reports for a psychiatric assessment saying that her mother is worried about her, claiming that she gets moody around that time of the year each and every year.

Chief complaint.

The patient provides some very vital information during her assessment. She clearly points out that it was her mother who asked her to seek help as she appears gloomy and moody at that particular time of the year each year. The patient also says that she has had difficulty concentrating and understanding what she learns in school. She has begun perceiving her friends as boring and annoying of late. The patient also complains of reduced interest in activities that she enjoyed before, a particular dislike to the cold weather that accompanies the winter season and an alteration in her sleeping and eating habits.

History of Presenting Illness.

 The symptoms have greatly affected both her social life and her school work. At school, she is currently behind on two projects and has difficulty concentrating and understanding what they learn, symptoms that according to Barateau et al. (2017 Assignment Assessing and Diagnosing Patients With Mood Disorders), indicate an underlying problem. She has also fallen asleep five times in class over the last month. She has gained ten pounds as a result of her change in eating habits. Her social life has also been impacted greatly as she no longer wants to hang out with her friend whom she perceives as boring and has lost interest in activities that excited her in the past.

During the assessment, it is obvious that the patient is unaware of her condition. The patient says that it was her mother pushing her to seek help and she was not aware that she had any problem. The patient is also indecisive. She constantly changes her answers to the questions that she is being asked by the psychiatrist assessing her. In the initial stages, she says that school is okay but changes her answer a few minutes later saying that things were not going on well. The patient is also hesitant in her speech, constantly pausing before answering questions posed to her.

Mental Status Examination.

On examination, the patient is neat and well kempt, conscious, has reduced attention levels, normal motor functions and speech. The mood and affect are congruent with the patient having a blunt affect and stating that she is feeling gloomy and sad. She has poor insight into her condition. The patient is well oriented in time, place and person, aspect that Foley et al. (2017 Assignment Assessing and Diagnosing Patients With Mood Disorders) identify as vital in psychiatric assessments. Her level of concentration is reduced and she hardly maintains appropriate eye contact with her assessor. Her immediate, short-term and long-term memory are intact. The patient’s intelligence level is okay as she is able to correctly answer a few general knowledge questions posed by the psychiatrist. Her judgement is also not affected.

Differential Diagnosis.

The differential diagnosis in this patient includes seasonal affective disorder, dysthymic disorder and major depression. Seasonal Affective Disorder is a type of depression that is commonly observed in a seasonal pattern. Symptoms are usually more obvious during winter when the days are cold and gloomy. It is also characterized by persistent low mood, a loss of interest in activities that one enjoyed before, change in both sleep patterns and feeding habits, consequently resulting in an increase in weight (Meyerhoff, Young, & Rohan, 2018 Assignment Assessing and Diagnosing Patients With Mood Disorders).

The diagnosis of Seasonal Affective Disorder is supported by the patient when she says that her mother claims that she gets gloomy around a specific time of the year, each and every year. The patient also points out that she specifically dislikes the cold weather saying that it is miserable and results in her not engaging in activities that excite her during summer. The patient is also highly irritable claiming that her friends constantly annoy her of late. She has had a change in both her sleeping and eating habits having gained ten pounds. Assignment Assessing and Diagnosing Patients With Mood Disorders

The symptoms have been very severe and have had a major impact on her overall life. She has slept through five of her classes over the past month, losing concentration and failing to understand what she is taught in class. She has also fallen behind on two of her school projects. Her social life has also been affected with her friends currently annoying her and she is seeing no need of spending time with them. Assignment Assessing and Diagnosing Patients With Mood Disorders

The other differential is dysthymic disorder. Dysthymic disorder is a persistent form of depression characterized by reduced energy levels, change in feeding habits, hypersomnia or insomnia, reduced productivity and self-esteem, loss of interest in day-to-day tasks and an overall feeling of inadequacy (Zangani et al., 2021 Assignment Assessing and Diagnosing Patients With Mood Disorders). The patient is clearly demonstrating a majority of the above symptoms and they have greatly impacted her life, altering her social life and interaction with friends and impacting her school work.

The third differential diagnosis is major depression. The DSM-5 criteria for diagnosing major depression includes depressed mood, reduced interest and pleasure in almost all activities, altered eating habits leading to either weight gain or weight loss, sleep disturbances, reduced energy levels, diminished concentration levels and psychomotor agitation (Zahl, Steinsbekk, & Wichstrøm, 2017). The patient in the scenario clearly demonstrates a majority of these symptoms.

Primary Diagnosis.

My primary diagnosis is Seasonal Affective Disorder. The symptoms clearly present at a particular time, evidenced by the patient’s mother telling her to seek help as she appears moody at specific times of the year annually. The patient also clearly points out her dislike for the cold weather observed during winter, which is a classic symptom of Seasonal Affective Disorder. These presentations coupled with reduced energy levels, reduced pleasure in almost all activities, change in both eating and sleeping habits and loss of concentration support the diagnosis of Seasonal Affective Disorder.

Reflection Notes.

If I were to conduct the session all over again, I would like to engage an informant, such as the patient’s mother, to give me further insight into the patient’s condition. I would further inquire about any traumatizing incidences that the patient has witnessed or experienced in the past, and especially during winter, that have built the strong dislike in her towards winter. Asking about recent drug use is also key to help in ruling out drug induced depression.

It would also be important to highlight the significance of her moving away from home to a big city, something that Lee et al. (2021 Assignment: Assessing and Diagnosing Patients With Mood Disorders) identify as a contributing factor to seasonal affective disorder. It is important to know how she felt and feels after leaving her family back at home and leaving with new roommates outside campus. I would ask her about how the pressures of campus have affected her overall well-being, including both her social life and her mental health. Assignment Assessing and Diagnosing Patients With Mood Disorders

Legal/ Ethical Considerations.

Some of the key ethical/ legal considerations to consider while assessing a psychiatric patient other than confidentiality and consent include conflict of interest, therapeutic misconceptions, placebo related considerations, vulnerability, exploitation, operational challenges among other considerations (Bennett et al., 2017 Assignment Assessing and Diagnosing Patients With Mood Disorders). Conflict of interest is demonstrated in an instance where a health care professional has an inappropriate relationship with his or her patient or shares a patient’s personal information with another professional without consent to do so.

Vulnerability expounds on the professional offering the best services to his or her patient without exploiting them, understanding that their patient is vulnerable as a result of his mental health status. Respect is another key ethical consideration. Providing the highest quality care to all patients without favour or discrimination of social class, race, political or religious affiliation is something that every health professional must strive to do. Assignment Assessing and Diagnosing Patients With Mood Disorders

Health Promotion and Disease Prevention.

In assessing health promotion and disease prevention factors, it is important to take into consideration the patient’s age, ethnic group and other predisposing factors. Health promotion measures that raise awareness concerning mental health issues, improving mental health literacy, reducing stigma associated with mental health and maximising individuals and collective mental health and well-being.

These can be achieved by providing the necessary information and education about mental health, engaging in activities that aid in the promotion of mental health, carrying out initiatives that raise the awareness of mental health among the community and working towards reducing both discrimination and stigma towards people with mental health challenges (Ramchand et al., 2017 Assignment: Assessing and Diagnosing Patients With Mood Disorders).

These initiatives and programmes can be carried out by the government, non-profit organisations and campuses to raise awareness about the importance of mental health. Engaging young people in activities such as hikes and seminars can go a long way in promoting mental health awareness while also providing a platform to share their challenges and ways to overcome them. Assignment Assessing and Diagnosing Patients With Mood Disorders

Conclusion

The mental health status of an individual is particularly important as it affects their overall well-being. The recent surge in mental health related issues has led to a demand in the need to raise awareness concerning the issue. Mood disorders and other major mental health issues are some of the many challenges plaguing a majority of individuals today, and especially the young population. Every one of us has a major part to play in raising the awareness of mental health issues. In the presented case of 19-year-old Ms. Julie Houston, she is likely suffering from Seasonal Affective Disorder, a type of psychiatric illness that changes with seasons as described in the paper. Assessment and management of the condition in a timely manner can help relieve the symptoms.

Assignment: Assessing and Diagnosing Patients With Mood Disorders References.

• Barateau, L., Lopez, R., Franchi, J. A. M., & Dauvilliers, Y. (2017). Hypersomnolence, hypersomnia, and mood disorders. Current Psychiatry Reports, 19(2), 13. https://doi.org/10.1007/s11920-017-0763-0
• Bennett, B., McDonald, F., Beattie, E., Carney, T., Freckelton, I., White, B., & Willmott, L. (2017). Assistive technologies for people with dementia: ethical considerations. Bulletin of the World Health Organization, 95(11), 749–755. https://doi.org/10.2471/BLT.16.187484
• Foley, J. A., Vinke, R. S., Limousin, P., & Cipolotti, L. (2017). Relationship of cognitive function to motor symptoms and mood disorders in patients with isolated dystonia. Cognitive and Behavioral Neurology, 30(1), 16-22. https://doi.org/10.1097/WNN.0000000000000117
• Lee, K. J., Lee, K., Lee, Y. M., & Choi, H. S. (2021). Survey of Frontline Police Officers’ Responses and Requirements in Psychiatric Emergency Situations. International Journal of Environmental Research and Public Health, 18(1), 237. https://doi.org/10.3390/ijerph18010237
• McElroy, S. L., Guerdjikova, A. I., & Romo-Nava, F. (2021). Diagnosing and treating major depressive episodes that lie along the mood disorders spectrum: focus on depression with mixed features. CNS Spectrums, 26(2), 133-139. https://doi.org/10.1017/s1092852921000262
• Meyerhoff, J., Young, M. A., & Rohan, K. J. (2018). Patterns of depressive symptom remission during the treatment of seasonal affective disorder with cognitive‐behavioral therapy or light therapy. Depression and Anxiety, 35(5), 457-467. doi: 10.1002/da.22739.

Assignment Assessing and Diagnosing Patients With Mood Disorders Instructions

Also Read: NURS 6053 Psychotherapy for Clients with Addictive Disorders Paper