Case Study Kel Purpose Analyze And Apply Critical Thinking S

Case Study Kelpurposeanalyze And Apply Critical Thinking Skills In T

Describe the presenting problems. Generate a primary and differential diagnosis using the DSM5 and ICD 10 codes. Formulate and prioritize a treatment plan. Identify and discuss appropriate screening instruments for a patient who has suicidal ideation.

Paper For Above instruction

The case of Kel presents a complex picture of severe depressive symptoms accompanied by potential suicidal ideation, meriting careful clinical assessment and intervention. Kel, a 42-year-old CPA, exhibits hallmark signs of major depressive disorder (MDD), including persistent low mood, fatigue, anhedonia, significant weight loss, psychomotor retardation, social withdrawal, and expressions of hopelessness and worthlessness. Her inability to engage in daily activities, neglect of personal appearance, and deterioration of functioning suggest a major depressive episode with considerable severity (American Psychiatric Association, 2013).

The primary clinical problem manifested by Kel is a profound depressive episode significantly impairing her social, occupational, and personal functioning. Her lack of energy to perform everyday tasks, diminished interest in work and personal care, weight loss over a brief period, and pervasive sadness are characteristic of MDD, as classified in DSM-5 and ICD-10 (WHO, 1992). The fact that she reports feeling "sad and hopeless" and perceives herself as a "bad person" further confirms the severity of her depression and suggests the presence of negative cognitive distortions often associated with this disorder.

In addition to the primary diagnosis, differential diagnoses should consider other psychiatric conditions that may present with overlapping features. These include dysthymic disorder, although her symptoms seem more severe and acute; depressive episodes secondary to medical conditions such as hypothyroidism, which necessitates ruling out medical causes through laboratory testing; and substance-induced mood disorder if relevant substance use is suspected—though this has not been indicated in the case. Given her presentation, generalized anxiety disorder appears less likely but should remain as a differential if anxiety symptoms persist or emerge in treatment (APA, 2013).

The ICD-10 code for a current depressive episode, moderate to severe, could be F32.2 or F32.3, depending on the severity and duration (WHO, 1992). The DSM-5 diagnosis would be Major Depressive Disorder, single episode, severe, without psychotic features, coded 296.23, pending confirmation of symptom duration and impairment.

Prioritizing her treatment involves establishing immediate safety due to her expression of hopelessness and potential suicidal ideation. An initial step should include risk assessment for suicide, involving screening tools specifically designed to evaluate ideation, intent, and plan, such as the Columbia-Suicide Severity Rating Scale (C-SSRS). Concurrently, initiating psychotherapy—preferably cognitive-behavioral therapy (CBT)—aims to address negative thought patterns and develop coping strategies. Pharmacotherapy with selective serotonin reuptake inhibitors (SSRIs) should be considered, balancing efficacy with side effect profiles and monitoring requirements. Family support and psychoeducation will be essential components of her ongoing care plan.

Understanding her risk factors for suicidality necessitates use of specific screening instruments. The Patient Health Questionnaire-9 (PHQ-9), which includes a question about thoughts of self-harm or death, offers an initial screening method. For more comprehensive risk assessment, the Beck Scale for Suicide Ideation (BSS) provides a detailed evaluation of suicidal thoughts, severity, and intent. These tools facilitate early identification of suicidal ideation and guide clinical decision-making regarding hospitalization, safety planning, and intervention urgency (Joiner et al., 2005).

In conclusion, Kel’s presentation warrants urgent clinical attention focusing on safety assessment, evidence-based pharmacological and psychotherapeutic interventions, and ongoing monitoring. Early recognition via validated screening tools is vital in preventing suicide and improving prognosis. Comprehensive, patient-centered care that addresses her psychological, social, and biological needs is essential to facilitate recovery and restore her functioning.

References

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
  • Joiner, T. E., Jr., Van Orden, K., Witte, T., & Gibbons, M. (2005). The Interpersonal Theory of Suicide. In J. L. Mathews & K. G. Collet (Eds.), Advances in Neuropsychiatry and Psychopharmacology (pp. 59–75). Springer.
  • World Health Organization. (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines.
  • Zimmerman, M., & Martinez, J. (2010). Diagnostic accuracy of brief screening tests for depression. Journal of Clinical Psychiatry, 71(7), 954-961.
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  • Beck, A. T., Steer, R. A., & Ranieri, W. F. (1988). The Beck Depression Inventory: Manual. Harcourt Brace Jovanovich.
  • Rush, A. J., Trivedi, M. H., Wisniewski, S. R., et al. (2006). Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: A STAR*D report. American Journal of Psychiatry, 163(11), 1905-1917.
  • Hawton, K., & van Heeringen, K. (2009). Suicide. The Lancet, 373(9672), 1372-1381.
  • Schaffer, A., & Blease, C. (2018). Managing suicidality in primary care. Australian Family Physician, 47(7), 475-479.
  • Oquendo, M. A., et al. (2004). Suicidal behavior and suicidal ideation. The Journal of Clinical Psychiatry, 65(Suppl 3), 37-41.

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