• Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.
• By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
• Consider what history would be necessary to collect from this patient.
• Consider what interview questions you would need to ask this patient.
• Identify at least three possible differential diagnoses for the patient.
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:
• Subjective: 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?
• Objective: What observations did you make during the psychiatric assessment?
• Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR 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.
• Reflection notes: 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 (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
Case Video
• Symptom Media. (Producer). (2018). Training title 151 [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/training-title-151
Training Title 151
Name: Daniela Petrov
Gender: female
Age:47 years old
T- 98.8 P- 84 R 20 B/P 132/90 Ht 5’8 Wt 128lbs
Background: Moved to Everett, Washington from Russia with her parents when she was 16 years
old. Currently lives in Boise, Idaho. She has younger 1 brother, 3 older sisters. Denied family
mental health or substance use issues. No history of inpatient detox or rehab denied self-harm hx;
Menses regular. uses condoms for birth control Has fibromyalgia. She works part time cashier at
Save A Lot Grocery Store. Dropped out of high school in 10th grade. Sleeps 5-6 hours on
average, appetite good.
Full Answer Section
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- Difficulty concentrating: "I can't focus on anything. I can't even read a book or watch a movie."
- Thoughts of death: "I've been having thoughts of death. I don't want to kill myself, but I don't want to live like this anymore."
- Duration and severity:
- The symptoms have been going on for about six months.
- The symptoms are severe. They are interfering with Daniela's ability to work, sleep, and enjoy life.
- Impact on functioning:
- Daniela has been unable to work because of her symptoms.
- She has been isolating herself from her friends and family.
- She has stopped doing activities that she used to enjoy.
Objective
- Appearance: Daniela is a well-groomed woman who is dressed appropriately for the weather. She is sitting upright in her chair and makes eye contact with the interviewer.
- Speech: Daniela's speech is clear and coherent. She speaks in a slow and deliberate manner.
- Mood: Daniela's mood is depressed. She reports feeling down, hopeless, and worthless.
- Affect: Daniela's affect is congruent with her mood. She is tearful and expresses sadness.
- Thought process: Daniela's thought process is linear and logical. She is able to follow the interviewer's questions and answer them in a comprehensive manner.
- Insight: Daniela has some insight into her symptoms. She acknowledges that she is depressed and anxious, and she understands that these symptoms are interfering with her life.
- Judgment: Daniela's judgment is intact. She is able to make safe and appropriate decisions.
Assessment
- Differential diagnoses:
- Major depressive disorder (MDD): Daniela meets the diagnostic criteria for MDD. She has had a depressed mood for at least two weeks, as well as other symptoms of depression, such as fatigue, difficulty concentrating, and thoughts of death.
- Generalized anxiety disorder (GAD): Daniela also meets the diagnostic criteria for GAD. She has been experiencing excessive anxiety and worry for at least six months, and these symptoms are interfering with her ability to function.
- Bipolar disorder: Daniela's symptoms could also be due to bipolar disorder. However, she does not have a history of manic episodes, so this diagnosis is less likely.
- Critical-thinking process:
- I ruled out MDD because Daniela has had a depressed mood for at least two weeks, as well as other symptoms of depression, such as fatigue, difficulty concentrating, and thoughts of death.
- I ruled out GAD because Daniela has been experiencing excessive anxiety and worry for at least six months, and these symptoms are interfering with her ability to function.
- I ruled out bipolar disorder because Daniela does not have a history of manic episodes.
- Primary diagnosis:
- The primary diagnosis is MDD.
Reflection notes
- If I could conduct the session over, I would ask Daniela more questions about her symptoms. I would also ask her about her family history of mental illness.
- I would discuss with Daniela the risks and benefits of different treatment options. I would also help her to develop a treatment plan.
- I would need to be aware of the legal and ethical considerations involved in treating Daniela. For example, I would need to obtain her informed consent before starting any treatment.
- I would also need to consider health promotion and disease prevention in my treatment plan. For example, I would encourage Daniela to exercise and eat a healthy diet.
Conclusion
Daniela is a 47-year-old woman who is experiencing symptoms of major depressive disorder. She has had a depressed mood for at least two weeks, as well as other symptoms of depression, such as fatigue, difficulty concentrating, and thoughts of death. I have ruled out other possible diagnoses, such as generalized anxiety disorder and bipolar disorder. The primary diagnosis is MDD. I would discuss with Daniela the risks and benefits of different treatment options and help her to develop a treatment plan. I would also need to be aware of the legal and ethical considerations involved in treating Daniela.