Goal To Analyze And Apply Critical Thinking Skills In Psycho

Goalto Analyze And Apply Critical Thinking Skills In The Psychopathol

Analyze and apply critical thinking skills in the psychopathology of mental health patients, providing treatment and health promotion based on evidence-based research. Present a case of Helen, a 45-year-old African American female who has recently experienced increasing symptoms of depression and anxiety following a personal life stressor. Summarize her clinical presentation, diagnose her according to DSM-5 criteria, and develop a comprehensive treatment plan including both pharmacological and non-pharmacological interventions. Justify the choice of treatments considering safety, efficacy, costs, and patient adherence. Support your recommendations with current academic sources, citing in APA style.

Paper For Above instruction

Helen, a 45-year-old African American woman, presents with symptoms that have progressively worsened over the past three months. She reports increased anxiety, difficulty sleeping, and daytime fatigue, which in the last month have intensified into feelings of profound sadness, guilt, poor appetite, and low energy. Despite these symptoms, she denies suicidal ideation but expresses a sense that "life is not worth living," indicating a significant depressive mood (American Psychiatric Association [APA], 2013). Helen’s personal and family history reveal no prior psychiatric illnesses. She is a working mother managing household responsibilities, caring for her twins, and maintaining a part-time job, which further underscores her stress levels. Her medical history includes lower-extremity neuropathy of unknown origin, and she uses alcohol sparingly, suggesting minimal risk of substance misuse contributing to her current presentation.

The constellation of symptoms aligns with a major depressive episode, particularly given her persistent low mood, anhedonia, guilt, and sleep disturbances, consistent with DSM-5 criteria for major depressive disorder (MDD) (APA, 2013). The DSM-5 stipulates that at least five symptoms must be present during the same two-week period, representing a change from previous functioning, and include either depressed mood or loss of interest/pleasure. Helen’s symptoms conform to these criteria, including depressed mood, diminished interest, sleep disturbance, fatigue, guilt, and impaired functioning.

Based on her clinical presentation, the most appropriate DSM-5 diagnosis is Major Depressive Disorder, Single Episode, Moderate Severity. The diagnosis is supported by her symptoms' duration (more than two weeks), their impact on daily functioning, and absence of psychotic features or bipolar features. No evidence suggests comorbid anxiety disorder, although her anxiety symptoms warrant monitoring.

In accordance with clinical guidelines, pharmacological intervention is recommended to alleviate her depressive symptoms. Selective Serotonin Reuptake Inhibitors (SSRIs) are first-line treatments for MDD due to their safety profile, efficacy, and tolerability (Cipriani et al., 2018). Specifically, sertraline is widely prescribed because of its favorable side effect profile and evidence supporting its use in diverse populations, including African Americans (Williams et al., 2016).

Therefore, I recommend initiating sertraline at a starting dose of 50 mg once daily. This dosage is supported by guidelines as an effective initial dose with a manageable side effect profile (NICE, 2019). The medication’s benefits include improvement in mood, energy, and sleep patterns, which are essential for restoring Helen’s functional capacity. Dosage can be titrated upward based on response and tolerability, with typical maximum doses around 200 mg/day (Tufts Medical Center, 2020). Cost considerations are crucial; at a local pharmacy, a 30-day supply of generic sertraline (50 mg) costs approximately $10–15, making it affordable for most patients (GoodRx, 2024). Safety concerns are minimal with SSRIs, but monitoring for adverse effects like gastrointestinal upset, sexual dysfunction, and potential increases in anxiety is necessary, especially during initial treatment phases. Adherence is encouraged through patient education about medication benefits, side effects, and the importance of regular follow-up.

Non-pharmacological strategies are essential complements to medication. Given her presentation, a highly effective non-pharmacological intervention is aerobic exercise, which has demonstrated benefits in reducing depressive symptoms independently or as an adjunct to pharmacotherapy (Schuch et al., 2016). An appropriate recommendation is 30 minutes of moderate-intensity aerobic activity—such as brisk walking—most days of the week. The benefits include improved mood, increased energy, and enhanced sleep quality. Exercise not only boosts endorphin levels but also improves self-efficacy and social functioning. Risks are minimal but include injury or overexertion; thus, initial guidance from a physical health professional is advised.

The combination of pharmacotherapy and exercise offers synergistic effects, increasing the likelihood of remission and recovery. The safety profile of exercise is excellent, costs are low, and adherence can be fostered through community programs or structured routines. Moreover, encouraging Helen to engage in routine physical activity aligns with health promotion principles by addressing her overall well-being and reducing the recurrence risk of depression (Cooney et al., 2013).

In conclusion, Helen’s clinical presentation aligns with a diagnosis of moderate major depressive disorder. An evidence-based treatment plan involving sertraline, an SSRI, combined with aerobic exercise, constitutes a comprehensive approach. Regular follow-up to monitor treatment response, side effects, and adherence is critical for optimal outcomes. Considering individual factors such as safety, cost, accessibility, and patient preferences enhances the likelihood of successful treatment and sustained mental health improvement.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Cipriani, A., et al. (2018). Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: A systematic review and network meta-analysis. The Lancet, 391(10128), 1357–1366.
• Cooney, G. M., et al. (2013). Exercise for depression. Cochrane Database of Systematic Reviews, (9), CD004366.
• GoodRx. (2024). Cost of generic sertraline. https://www.goodrx.com
• National Institute for Health and Care Excellence (NICE). (2019). Depression in adults: Recognition and management. NICE guidelines NG222.
• Schuch, F. B., et al. (2016). Physical activity and incident depression: A meta-analysis of prospective cohort studies. American Journal of Preventive Medicine, 51(2), 234–242.
• Tufts Medical Center. (2020). Sertraline (Zoloft): Drug information. https://www.tuftsmedicalcenter.org
• Williams, D. R., et al. (2016). Racial/ethnic differences in symptom severity and treatment response to pharmacotherapy for depression. American Journal of Psychiatry, 173(6), 620–629.