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

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Introduction:

The assignment given to medical college students requires them to conduct comprehensive psychiatric evaluation and diagnose mood disorders accurately. Students need to incorporate subjective, objective, assessment, and reflection notes in their responses. The assignment requires students to use a video to diagnose the mood disorder, which might pose a challenge. Additionally, ethical and legal considerations, patient factors, and risk factors should be considered while making the diagnosis.

1. 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?

The patient in the video presented with symptoms of depression, including sadness, losing interest in activities, decreased energy, and difficulty sleeping. She also reported experiencing anxiety, panic attacks, and suicidal thoughts for more than six months. The symptoms impacted her work, relationships, and daily functioning, indicating severe symptoms.

2. What observations did you make during the psychiatric assessment?

During the psychiatric assessment, I observed the patient’s speech, affect, mood, thought process, and cognitive function. The patient had a depressed mood, constricted affect, slow speech, and a negative thought process. The patient had a good cognitive function, and there were no signs of psychotic symptoms or delusions.

3. Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide three possible diagnoses with supporting evidence listed in order from highest 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.

Based on the patient’s symptoms and the mental status examination results, the differential diagnoses include Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), and Panic Disorder. MDD is the highest priority diagnosis as the patient presents with a depressed mood, loss of interest, fatigue, and suicidal thoughts. The DSM-5-TR criteria for MDD requires a certain combination of symptoms, including sadness or loss of interest, for at least two weeks, impacting daily life. GAD is the second differential diagnosis as the patient presents with symptoms such as worry, anxiety, and panic attacks. The DSM-5-TR criteria for GAD requires excessive worry and anxiety for six months or more, impacting daily life. Panic Disorder is the third differential diagnosis as the patient presents with panic attacks, which are sudden and very anxiety-provoking. The DSM-5-TR criteria for Panic Disorder requires recurrent and unexpected panic attacks with a persistent concern for further attacks. The critical-thinking process included ruling out other disorders such as bipolar disorder and psychotic disorders based on the lack of appropriate symptomology. Pertinent positives include a history of anxiety, while pertinent negatives include the absence of psychotic symptoms.

4. 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, health promotion and disease prevention taking into consideration patient factors, PMH, and other risk factors.

If I could conduct the session over, I would spend more time assessing the patient’s social and personal factors that might contribute to their mood disorders. It is essential to consider the patient’s cultural background, social support, and family history while making a diagnosis. Additionally, I would discuss the patient’s legal and ethical considerations and their consent to treatment comprehensively. I would also emphasize health promotion and disease prevention through lifestyle changes, such as exercise and therapy. The patient’s Past Medical History (PMH) might provide insight into their mental conditions, and other risk factors such as physical and sexual abuse could influence the diagnosis. Therefore, considering all these factors might lead to more accurate diagnosis and better outcomes in treating the patient’s mood disorder.