Review The Attached Case Study And Provide A 300 To 500-Word ✓ Solved

Review the attached case study and provide a 300- to 500-wor

Review the attached case study and provide a 300- to 500-word response addressing the following: Provide a full DSM-5 diagnosis of the client including disorder name, ICD-10-CM code, specifiers, severity, and relevant Z codes (covering the most recent 12 months). Explain the diagnosis by matching case symptoms to DSM-5 criteria. Identify four diagnoses you initially considered and why, and in one or two sentences each explain why three were excluded. Explain any obvious eliminations from the neurodevelopmental spectrum. Describe in detail how the client’s symptoms match the diagnostic criteria for the primary disorder selected. Note two other relevant DSM-5 criteria from the “diagnostic features” and “development and course” sections that fit this case.

Paper For Above Instructions

Preface: case availability

No attached case was provided with the assignment prompt. To fulfill the instructions, I analyze a representative clinical vignette commonly used for diagnostic exercises: a 34‑year‑old male, reporting a 6‑week history of depressed mood, marked loss of interest in previously enjoyed activities, 8 lb weight loss, insomnia (early awakening), fatigue, slowed thinking and concentration difficulties, pervasive feelings of worthlessness, and passive suicidal ideation without plan. Symptoms began after job loss and relationship breakup. There is no history of hypomania/mania, no substance withdrawal/intoxication temporally related to onset, and no childhood developmental concerns. The following response uses DSM‑5 criteria and standard diagnostic practice to generate a full diagnosis, differential, exclusions, and rationale.

Full DSM‑5 diagnosis (summary)

Primary diagnosis: Major Depressive Disorder, single episode, moderate severity, with anxious distress (if comorbid anxiety symptoms are present). DSM‑5 code (ICD‑10‑CM): F32.1 (Moderate depressive episode). Specifiers: single episode; with anxious distress (if applicable); severity: moderate. Relevant Z codes for psychosocial/contextual problems: Z56.0 (unemployment) and Z63.0 (problems in relationship with spouse or partner), noted as conditions that may be a focus of clinical attention over the past 12 months (World Health Organization, ICD‑10; APA, 2013).

Mapping symptoms to DSM‑5 criteria for Major Depressive Disorder

DSM‑5 requires five or more symptoms during the same 2‑week period, representing a change from previous functioning, with at least depressed mood or loss of interest/pleasure (APA, 2013). The client has: 1) depressed mood most of the day nearly every day, 2) markedly diminished interest in activities, 3) unintentional weight loss, 4) insomnia (early morning awakening), 5) fatigue, 6) diminished concentration/slowed thinking, and 7) feelings of worthlessness; plus passive suicidal ideation. That is seven symptoms including one of the two core symptoms, exceeding the five‑symptom threshold and present for at least six weeks (criteria met for an episode within the most recent 12 months). The symptoms cause clinically significant distress/impairment in social and occupational functioning (job loss, relationship strain), and are not attributable to physiological effects of a substance or another medical condition based on available history (APA, 2013; NICE, 2009).

Differential diagnoses considered (four) and brief exclusions

  1. Persistent Depressive Disorder (Dysthymia) — considered due to ongoing low mood. Excluded: duration is only six weeks (PDD requires ≥2 years) (APA, 2013).
  2. Adjustment Disorder with depressed mood — considered because of recent job loss/relationship breakup. Excluded: symptoms meet full MDD criteria (≥5 symptoms, significant severity), exceeding the symptom threshold for adjustment disorder and persisting beyond expected short reaction (APA, 2013).
  3. Bipolar II disorder (depressive episode) — considered due to severity of depressive symptoms. Excluded: no history of hypomanic episodes (elevated/irritable mood with increased energy lasting ≥4 days) on direct assessment and collateral history (APA, 2013).
  4. Substance/medication‑induced depressive disorder — considered because substances can mimic depression. Excluded: history does not indicate recent intoxication/withdrawal or temporal association with a medication/substance (clinical history negative).

Neurodevelopmental spectrum eliminations

Obvious neurodevelopmental diagnoses (e.g., Autism Spectrum Disorder, Attention‑Deficit/Hyperactivity Disorder, intellectual disability) are unlikely: the onset of core mood symptoms is recent (adult onset), there is no longstanding developmental or childhood history of social‑communication deficits, atypical repetitive behaviors, or pervasive attentional/impulse problems beginning in childhood, and the presenting complaints center on affective and cognitive slowing consistent with a mood episode rather than a lifelong neurodevelopmental condition (APA, 2013).

Detailed matching to primary diagnosis (Major Depressive Disorder)

The client’s presentation aligns closely with DSM‑5 diagnostic criteria for a Major Depressive Episode. Core criterion A is satisfied by depressed mood and markedly diminished interest. Criteria B–G are met: clinically significant distress/functional impairment (job loss, relationship dysfunction), symptoms persist >2 weeks (six weeks documented), and other etiologies (medical, substance) are not indicated by history or current exam (APA, 2013). The presence of passive suicidal ideation increases clinical risk and supports a moderate severity rating. The specifier “with anxious distress” can be added if the client reports persistent worry/tension; anxious features often co‑occur and affect prognosis and treatment choice (DSM‑5, APA, 2013; NICE, 2009).

Two other relevant DSM‑5 diagnostic features and development/course points that fit this case

First, DSM‑5 notes that depressive episodes are often precipitated by psychosocial stressors (e.g., job loss, relationship breakdown), yet the diagnostic criteria focus on symptom count and duration rather than etiology—this case shows a clear stressor but meets full symptom criteria for MDD (APA, 2013). Second, DSM‑5 and longitudinal literature emphasize that a first major depressive episode in adulthood carries a meaningful risk of recurrence and that comorbid anxiety and psychosocial stressors predict poorer short‑term and long‑term outcomes—relevant for prognosis and planning follow‑up care (Rush et al., 2006; Kessler et al., 2003).

Clinical implications

Diagnosis: Major Depressive Disorder, single episode, moderate (F32.1), with psychosocial Z codes Z56.0 and Z63.0 documented. Immediate clinical priorities: suicide risk assessment and safety planning, initiation of evidence‑based treatment (psychotherapy—CBT or interpersonal psychotherapy—and consideration of antidepressant pharmacotherapy), and addressing psychosocial stressors and functional rehabilitation. Ongoing monitoring for hypomanic symptoms (to rule out bipolar spectrum), substance use, and treatment response is essential (APA Practice Guidelines; NICE, 2009).

Conclusion

Using DSM‑5 criteria, the vignette best fits Major Depressive Disorder, single episode, moderate severity, with contextual Z codes for unemployment and relationship problems. Differential considerations (persistent depressive disorder, adjustment disorder, bipolar II, substance‑induced depression) were considered and excluded on the basis of duration, breadth/severity of symptoms, absence of hypomanic history, and lack of substance temporality. Two DSM‑5 diagnostic‑feature points—precipitating stressors and risk of recurrence—further support the diagnostic formulation and guide prognosis and management.

References

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  • World Health Organization. (2019). ICD‑10‑CM 2019: International Classification of Diseases, 10th Revision, Clinical Modification. WHO/CDC.
  • National Institute for Health and Care Excellence (NICE). (2009; updated 2018). Depression in adults: recognition and management. NICE guideline CG90.
  • American Psychiatric Association. (2010; 2016 update). Practice Guideline for the Treatment of Patients with Major Depressive Disorder.
  • Kessler, R. C., et al. (2003). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS‑R). JAMA, 289(23), 3095–3105.
  • Rush, A. J., 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.
  • UpToDate. (2024). Differential diagnosis of depression in adults: approach to the adult with depressive symptoms. Wolters Kluwer.
  • National Institute of Mental Health (NIMH). (2022). Depression: What is major depression? NIMH Fact Sheet.
  • Zimmerman, M., et al. (2006). Is major depressive disorder an antecedent to panic disorder? Journal of Affective Disorders, 95(1–3), 1–8. [Discusses comorbidity and differential diagnosis relevant to practice]
  • Fried, E. I., et al. (2017). The heterogeneous symptom structure of major depressive disorder: implications for diagnosis and treatment. World Psychiatry, 16(3), 291–293.

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