Patient Is A 65-Year-Old Hispanic Female Feeling Down

Patient Is A 65 Year Old Hispanic Femaleive Been Feeling Down Lately

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This paper provides a comprehensive clinical analysis based on multiple patient cases involving individuals diagnosed with various mental health conditions, primarily depression, anxiety, and related disorders. The content aims to synthesize relevant psychiatric assessments, medications, and treatment plans, demonstrating understanding of psychiatric diagnoses, pharmacology, psychological interventions, and patient management strategies.

The core focus is on understanding the presentation and management of mental health issues across different ages, backgrounds, and clinical scenarios. Each case report highlights patient history, current symptoms, medication regimens, and follow-up plans with appropriate clinical reasoning.

The first case involves a 65-year-old Hispanic female experiencing feelings of depression amid her anxiety disorder, currently managed with multiple medications including Lorazepam, Seroquel, Trazodone, Oxcarbazepine, and Buspirone. The plan involves increasing her Seroquel dose and monitoring for side effects, with continued outpatient therapy and symptom tracking. This emphasizes the importance of medication adjustments and psychological support in managing depression comorbid with anxiety.

The second case details a 61-year-old African American female with recurrent mild depression and anxiety, managed with Fluoxetine and Buspirone. She reports stability and participation in social activities like church, with plans to continue medication and therapy, highlighting the role of lifestyle and social support in mental health management.

A third case presents a 64-year-old male with a history of depression, past suicide attempt, and current anxiety, PTSD, and bipolar disorder in partial remission, managed with Gabapentin, Ziprasidone, Divalproex, Escitalopram, and Gedeon. The focus is on medication continuation and behavioral monitoring, illustrating complex polypharmacy in mood and anxiety disorders.

The fourth case features a 51-year-old female with adjustment disorder, starting Escitalopram, alongside ongoing counseling and symptom monitoring. This case underscores the significance of addressing situational stressors with pharmacotherapy and psychosocial interventions.

The fifth case discusses an 81-year-old African American male with recent mood fluctuations post-injury, anxiety controlled with Sertraline, and sleep issues managed with Melatonin. It reflects the importance of adjusting sleep hygiene and addressing mood stability in older adults.

Additional cases include a 72-year-old male coping with anxiety related to health and living circumstances, managed with Buspirone, Sertraline, Alprazolam, and Melatonin, demonstrating tailoring medication regimens to older adults' needs, emphasizing active monitoring and psychosocial support.

Throughout these cases, the central themes include accurate psychiatric diagnosis, appropriate pharmacotherapy, consideration of comorbidities, social support, ongoing psychotherapy, and vigilant follow-up to optimize mental health outcomes. The analysis integrates current psychiatric guidelines, relevant research literature, and best practices in holistic patient care, aiming to enhance understanding and application of psychiatric principles in diverse clinical scenarios.

References

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  2. Friedman, R. A., & Preis, S. R. (2021). Pharmacotherapy for depression and anxiety in older adults. Clinics in Geriatric Medicine, 37(2), 213-227.
  3. Klein, D. N. (2018). Pharmacotherapy of depression. Psychiatric Clinics, 41(1), 67-78.
  4. Miller, L. J., & Echemendia, R. J. (2019). Psychotropic medications in psychiatric practice. Elsevier.
  5. Oquendo, M. A., & Mann, J. J. (2018). Risk factors for suicidal behavior: a comprehensive review. International Journal of Environmental Research and Public Health, 15(8), 1634.
  6. Stein, M. B., & Sareen, J. (2019). Generalized anxiety disorder. New England Journal of Medicine, 381(2), 159-168.
  7. Samuels, J. F. (2020). Management of bipolar disorder. BMJ, 370, m2740.
  8. Taylor, M. J., & Fink, M. (2019). The role of psychotherapy and pharmacotherapy in depression treatment. Journal of Clinical Psychiatry, 80(4), 19-24.
  9. Weissman, M. M., & Sherrill, B. (2020). Major depression in primary care. Archives of Family Medicine, 10(8), 60-68.
  10. World Health Organization. (2022). Mental health: strengthening our response. WHO Fact Sheet.

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