NR 603 Week 6 Part 2 Mental Health Disorders

NR 603 Week 6 Part 2 Mental Health Disorders

Dr. Deering,

Major depressive disorder (MDD) is considered one of the top reasons for disability in the United States (WHO, 2018). Depression affects 350 million people worldwide. It is more prevalent in women than men. This disorder can go undetected for many years, often leading to increased morbidity from other physical illnesses, substance abuse, and increased suicidal ideations. As healthcare providers, it is important to conduct a complete history and physical, and use appropriate screening tools, such as PHQ-9, to diagnose depression. While many concerning histories should be referred to a mental health specialist, healthcare providers can certainly initiate treatment to help alleviate their symptoms. Keeping an open line of communication with patients who suffer from depression will positively impact their lives and reduce the social stigma associated with MDD. The following information is the full five-point treatment plan and analysis for D.W’s plan of care.

Primary Diagnosis: Major Depressive Disorder, first episode

Diagnostic Testing: At this time, it is important to rule out medical conditions and medication regimens that may contribute to D.W’s symptoms. Unfortunately, there is no diagnostic testing for major depressive disorder (MDD). The guidelines from the American Psychiatric Association (APA, 2017) recommends a comprehensive physical examination, as well as a thorough review of medical history, medications, life stressors, and the presence of substance use disorder. D.W does not have medications or history of substance use that may contribute to her symptoms. She also does not have any family history of psychiatric disorders. However, D.W does have a couple life stressors. She was recently divorced a month ago, and is now the sole caretaker of her twin daughters. She also reports having increased stress with work deadlines as a human resources recruiter. The APA also recommends ruling out differential diagnoses that may mimic D.W’s depressive symptoms (APA, 2017). Therefore, the next valid step is to obtain laboratory tests, including complete blood count (CBC), comprehensive metabolic panel (CMP), thyroid-stimulating hormone (TSH), lipid panel, vitamin B12, and vitamin D levels. Assessment and screening must include a work-up to exclude other disorders, such as hypothyroidism, anemia, renal problems, cancers, or cardiac issues, that may cause similar symptoms (APA, 2017).

Once differential diagnoses have been addressed, utilizing the patient health questionnaire (PHQ) tool is the next step in D.W’s assessment. According to the US Preventive Services Task Force (USPSTF), the PHQ screening tool is one of the most common, non-invasive screening tools that can be performed to measure the severity of depression (Maurer, Raymond, & Davis, 2018). The PHQ can be an important tool to monitor and address the patient’s potential for uncontrolled depression because it encompasses a combination of the DSM-IV criteria for depression. If D.W’s screening is indicative of depression, another