Discussion Applying Differential Diagnosis To Depression ✓ Solved

Discussion Applying Differential Diagnosis To Depressive And Bipolar

Applying Differential Diagnosis to Depressive and Bipolar Disorders What is it truly like to have a mental illness? By considering clients’ lived experiences, a social worker becomes more empathetic and therefore better equipped to treat them. In this Discussion, you analyze a case study focused on a depressive disorder or bipolar disorder using the steps of differential diagnosis. To prepare: View the TED Talk “Depression, the Secret We Share” (TED Conferences, LLC, 2013) and compare the description of Andrew Solomon’s symptoms to the criteria for depressive disorders in the DSM-5. Next review the steps in diagnosis detailed in the Morrison (2014) reading, and then read the case of Angel provided for this Discussion, considering the client against the various DSM-5 criteria for depressive disorders and bipolar disorders.

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Full DSM-5 Diagnosis for the Client

The most appropriate diagnosis for Angel, based on her symptoms and the DSM-5 criteria, is Major Depressive Disorder (MDD), recurrent, moderate severity, without psychotic features (DSM-5 Code: 296.32). Considering the recent 12 months, Angel exhibits persistent feelings of worthlessness, hopelessness, diminished interest in activities, fatigue, and concentration difficulties that impair daily functioning. She reports episodes of low mood lasting most of the day nearly every day for at least two weeks, which aligns with the DSM-5 criteria. Additionally, there are no indications of manic or hypomanic episodes, ruling out Bipolar Disorder.

Matching Symptoms to Diagnostic Criteria

Angel’s symptoms fit the DSM-5 criteria for Major Depressive Disorder as follows: She reports feelings of persistent sadness and hopelessness, a lack of interest or pleasure in her usual activities, significant changes in sleep patterns, and fatigue. Her symptoms cause clinically significant distress and impairment in social and occupational functioning. There are no manic or hypomanic episodes reported or evidenced, which distinguishes her condition from Bipolar I or II disorders. Her symptoms have persisted for more than two weeks, consistent with the DSM-5 timeframe requirement. Additionally, her symptoms are not better explained by other medical conditions, substance use, or bereavement, per the diagnostic criteria.

Evidence-Based Measurement Instrument

The Patient Health Questionnaire-9 (PHQ-9) is a widely used validated screening tool for depression. It efficiently assesses severity and monitors treatment outcomes (Kroenke, Spitzer, & Williams, 2001). Administering the PHQ-9 to Angel will help validate her diagnosis, quantify symptom severity, and evaluate treatment progress over time, facilitating a data-driven clinical approach.

Treatment Recommendations

Based on her diagnosis, a combination of cognitive-behavioral therapy (CBT) and pharmacotherapy is recommended. CBT has strong empirical support for reducing depressive symptoms by restructuring maladaptive thought patterns (Beck, 2011). Pharmacologically, an SSRI such as sertraline may be prescribed, considering its efficacy and safety profile for moderate depression (Baldwin et al., 2014). A referral to a psychiatrist for medication management would be appropriate to optimize pharmacological treatment and monitor potential side effects. Regular follow-up appointments should be scheduled to assess response and modify treatment plans as needed.

In addition to direct clinical interventions, psychoeducation about depression, lifestyle modifications including physical activity, and social support enhancement are integral components of a comprehensive treatment plan (NICE, 2019). Addressing any co-occurring medical issues or psychosocial stressors is essential to achieving optimal outcomes.

References

• Baldwin, D. S., et al. (2014). Evidence-based pharmacological treatment of adult depression. The BMJ, 349, g5629.
• Beck, J. S. (2011). Cognitive Behavior Therapy: Basics and Beyond. Guilford Press.
• Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613.
• National Institute for Health and Care Excellence (NICE). (2019). Depression in adults: Recognition and management. NICE Guideline [NG222].
• TED Conferences, LLC. (2013). Depression, the secret we share [Video]. YouTube. https://www.ted.com/talks/andrew_solomon_depression_the_secret_we_share
• Morrison, B. (2014). Differential Diagnosis in Psychiatry. Oxford University Press.
• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
• World Health Organization. (2016). ICD-10 Classification of Mental and Behavioural Disorders.
• Harvard Medical School. (2009). Treating Depression: A Call for Action. Harvard Health Publishing.
• National Institute of Mental Health (NIMH). (2023). Major Depression. https://www.nimh.nih.gov/health/statistics/major-depression