Please read instructions below
APA format
Must have 5 scholarly references with intext citation
Turnitin report
Use the case study below to answer these two parts of the assigment.
Part 1
This assigment has two parts to it. Write what the 3 differential diagnoses are 150-to-200-word count. Taking into account the patient case study below and what are the criteria base on the DSM TR 5.
Differential diagnosis
1) Major Depressive Disorder (MDD)
2) Generalized anxiety disorder GAD
3) Post traumatic stress syndrome PTSD
Case study:
CC (chief complaint): “I have been feeling ashamed and worthless”
HPI: BD is a 38 y/o Caucasian male who presented to the outpatient services for a psychiatric evaluation for possible outpatient CBT. According to the patient, he received six weeks of CBT in this facility two years ago with positive results. The patient reported that it seems he divorced his wife for five years. He relocated to Chicago for a new job and to start a new life. The patient also reports having difficulty coming to terms with his previous attempt to commit suicide before his brother’s wedding. According to the patient, seems moving to Chicago two years ago, and his depression has gotten worst; he has developed anxiety and is finding it very difficult to gain control of his life. The patient reported an increase in ETOH use. BD is currently being treated with Sertraline 200 mg po daily, Buspirone 15mg PO TID PRN for anxiety, and Trazadone 150mg PO at bedtime for insomnia. According to BD, he has sought the help of a few different outpatient services for CBT therapy in Chicago, but none have been effective, like the one in the state of GA, where two years ago, he received CBT for six weeks. The patient took a leave and absence from his job in Chicago to return to Atlanta, GA, to seek the help of outpatient services, which he has found effective in the past.
Part 2
Reflection notes: Reflection notes: What would you do differently in a similar patient evaluation? Reflect on one social determinant of health according to the Healthy People 2030 (you will need to research) as applied to this case in the realm of psychiatry and mental health. As a future advanced provider, what are one health promotion activity and one patient education consideration for this patient for improving health disparities and inequities in the realm of psychiatry and mental health? Demonstrate your critical thinking.
Differential Diagnoses
- Major Depressive Disorder (MDD): The patient’s chief complaint of feeling ashamed and worthless, along with symptoms such as difficulty gaining control of life, worsening depression, and increased alcohol use, are consistent with MDD. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for MDD include the presence of depressed mood most of the day, nearly every day, along with diminished interest or pleasure in activities, significant weight loss or gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, feelings of worthlessness or excessive guilt, and recurrent thoughts of death or suicide.
- Generalized Anxiety Disorder (GAD): The patient’s reported anxiety, difficulty coming to terms with past suicide attempt, and the use of Buspirone for anxiety suggest the possibility of GAD. The DSM-5 criteria for GAD include excessive anxiety and worry about multiple events or activities, difficulty controlling the worry, restlessness or feeling on edge, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances.
- Post-Traumatic Stress Disorder (PTSD): The patient’s history of a suicide attempt before his brother’s wedding and difficulty with the event, along with his reports of anxiety and difficulty gaining control of his life, raise the possibility of PTSD. The DSM-5 criteria for PTSD include exposure to a traumatic event, intrusive symptoms such as distressing memories or nightmares, avoidance of stimuli associated with the trauma, negative changes in mood and cognition, heightened arousal and reactivity, and symptoms persisting for more than a month.
Part 2: Reflection Notes
In a similar patient evaluation, I would ensure a more comprehensive assessment by incorporating a detailed psychiatric history, including family psychiatric history, past treatment modalities, and response to interventions. It would be beneficial to conduct a thorough assessment of the patient’s social support systems, including relationships, living conditions, and work environment, to identify any factors contributing to their current mental health issues. Moreover, I would employ a trauma-informed approach during the evaluation to better understand the patient’s experiences and their impact on mental well-being.
One social determinant of health according to Healthy People 2030 that applies to this case is “Social Support.” Research indicates that strong social support systems can contribute to better mental health outcomes. In this case, the patient’s relocation to a new city, divorce, and the absence of effective outpatient services in Chicago may have negatively affected his social support network. Lack of social support can exacerbate symptoms of depression, anxiety, and post-traumatic stress. Recognizing and addressing social support deficits can be crucial in improving mental health outcomes for individuals.
As a future advanced provider, a health promotion activity for this patient could involve facilitating connections with local support groups, therapy groups, or community organizations that focus on mental health. Encouraging participation in such groups can provide the patient with a sense of belonging, emotional support, and an opportunity to share experiences with others facing similar challenges.
For patient education, it would be important to provide information about available community mental health resources, including outpatient services, counseling centers, and helplines. This education should emphasize the importance of seeking ongoing mental health support, self-care practices, and healthy coping strategies. Furthermore, addressing mental health stigma and promoting open discussions about mental health within the patient’s social circle can contribute to reducing disparities and inequities in mental health care.