MN 660 Patient Intake and History Case Study

MN 660 Patient Intake and History Case Study

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MN 660 Patient Intake and History Case Study

Patient Intake and History

The patient is a 26-year-old college graduate who is currently euthymic but who has a history of major depressive episodes.

He has experienced major depressive episodes, mostly untreated, of varying lengths and severities since he was a teenager.

His symptoms have included insomnia, despondent thoughts, depressed mood, low interest in activities, poor energy, and impaired cognition.

He says his self-esteem drops and he feels rejection-sensitive and guilt-ridden for no apparent reason.

He has never had suicidal thoughts.

 

Some of the depressive episodes have been incapacitating and have interfered with school and work.

He appears to have good interepisode recovery and is able to return to class and work.

The patient also has symptoms of social anxiety.

He is often nervous around new people and acquaintances.

He experiences anticipatory anxiety and will avoid certain social events.

These symptoms are present regardless of his affective state.

He has asked for a consultation because he has legal issues regarding drinking and driving that he thinks were likely fueled by his psychiatric symptoms.

At the time of the infraction (several months ago, just before graduating college), he had been started on a selective serotonin reuptake inhibitor (SSRI) for the depression and generalized anxiety disorder (GAD) symptoms.

Within days of starting he experienced elevated mood in a sustained fashion over several days.

He lost all anxiety, fear, and avoidance.

MN 660 Patient Intake and History Case Study

He was unusually talkative; had racing thoughts; was distractible, hyperactive, and impulsive; and had decreased need for sleep.

He exhibited grandiosity, in which he felt invincible and that the law did not apply to him; this led him to purposefully antagonize a man in a bar, drive while drinking, and challenge authority when police were called.

The mood elevation is complicated by the fact that the patient admits to heavy alcohol use on weekends throughout college.

The mood elevation abated with cessation of the SSRI treatment.

He has now completed college; he has few friends in the immediate area, but his family is very supportive.

He wants to be a news reporter and is planning on applying to graduate school.

The patient has no family history of bipolar disorder; his mother has GAD.

He is not currently taking any medications.

Vitals:

8

MN 660 Patient Intake and History Case Study

160/80

76

18

5’10ʺ

190lb

Please use the case study template to complete the case and answer the questions listed below:

Does the patient’s history support a diagnosis of bipolar disorder even though his symptoms appear to have been triggered by a selective serotonin reuptake inhibitor?

What would be the expected future course of illness for this patient?

If the patient develops another depressive episode, how would you treat it?

What medication would you choose? (There could be many correct answers.) What is the mechanism of action (MOA) of this medication? (Be specific: What receptor does it work on? etc.)

Provide three (3) references (Published in the last 5 years) on the medication treatment of mood disorders.

MN 660 Patient Intake and History Case Study

RUBRIC
Excellent Quality 95-100%	Introduction 45-41 points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.		Literature Support 91-84  points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.			Methodology 58-53 points Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met.
Average Score 50-85%	40-38 points More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided.		83-76  points Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration.			52-49  points Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met.
Poor Quality 0-45%	37-1 points The background and/or significance are missing. No search history information is provided.		75-1 points Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration.			48-1 points There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met
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