Maria E Lopez

The case of the 28-year-old female exhibit a number of disturbing signs. They include frequent headaches, chronic fatigue, sleep difficulties, lack of concentration, anxiety, loss of appetite, and weight loss. To help this patient, it is vital to analyze the symptoms correctly, provide a diagnosis, and consider the treatment options, as these can help reveal appropriate methods to heal the disorder.

One of the most crucial tasks of the symptoms analysis process is understanding the diagnosis. The symptoms exhibited by the patient hint towards the high likelihood of depression. This disorder is marked by the signs, which coincide with those revealed during patient’s evaluation. The patient experiences the depressed mood for the prolonged time period, and it affects her psychosocial functioning. The rationale for this diagnosis is built on the idea that patient constantly experiences lack of interest towards her life, even to those things, which brought her satisfaction in the past (Christensen et al., 2020). In addition, she feels guilty because she loses her children even though it is not true. There also exists a tight connection between the physical symptoms and psychological symptoms. Frequent headaches are also the sign signifying the high possibility of depression. There exists a causal link between headaches and psychiatric disorders supported by the evidence that headache complains account for 68% of patients with first-episode depression (Wei et al., 2016). However, in order to confirm presence of depression, special tests should be performed. 

The differential diagnosis, which should be also considered, is the tension type headache (TTH). It is a frequent type of headache where the patients suffer from mild or severe headache and experience disability at work and private life. This disorder is marked by the high socioeconomic burden and psychological disorders often accompany this condition (Song et al., 2016). Patients with TTH have no significant difference from those with migraine, which is often accompanied by depression (Song et al., 2016). For that reason, understanding the nature of the headache is vital, as it could help to form the right treatment strategy.   

Considering the possible diagnoses for the patient's medical condition, it is necessary to perform a special estimation. There are two most common depression screening tools for adults, the Patient Health Questionnaire (PHQ)-2 and PHQ-9, both of which perform clinically and diagnostically well (Siniscalchi et al., 2020). The screening tools proving the nature of the patient’s mood disorder can help to prescribe the right treatment. If the patient’s diagnosis of depression is confirmed, then cognitive-behavioral therapy and antidepressants, as well as electroconvulsive therapy should be prescribed. The reaction of the patient towards this treatment will result either in its continuation, or trying other treatment options like light therapy, transcranial magnetic simulation, vagal nerve simulation, deep brain stimulation and sleep deprivation treatment. However, if the patient’s evaluation proves the TTH, then EMG biofeedback, relaxing training, and specific analgesics could be prescribed as a treatment option. 

Providing the general guidelines is impossible in this case, as first of all, it is vital to understand the nature of the disorder. Currently, the action route includes the following steps:

a)Performing the tests to understand the psychological condition of the patient;

b)Choosing the appropriate treatment strategy taking into account the acquired diagnosis;

c) Evaluating the effectiveness of the treatment.

In conclusion, it is necessary to state that the situation under analysis demands accurate estimation of the symptoms. As the signs and symptoms indicate, depression is the most likely diagnosis. A confirmation is vital, however, before designing a treatment plan and considering the medications and strategies to help the patient.

Yordanis Santana Soayero

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Summarize the clinical case.

A 28-year-old woman has presented with the following symptoms: persistent headaches, exhaustion, problems sleeping, a lack of interest in activities, difficulty focusing, frequent weeping outbursts, a loss of appetite, and a 10-pound weight loss over the previous month. She takes ibuprofen for migraines and has no substantial medical or mental health history. Both drinking and drug use are something she says she never does. They have been married for two years and have two children.

  Create a list of the patient’s problems and prioritize them

· Headaches (dull, aching, and generalized)

· Fatigue and poor sleep quality

· Lack of interest in usual activities

· Loss of appetite and weight loss 

· Worried about "something bad" and "losing" her children

 Which diagnosis should be considered? What is your rationale for the diagnosis?

Depression: The patient's symptoms of “fatigue, lack of interest in usual activities, difficulty concentrating, and frequent crying spells, and weight loss could be consistent with depression” (Mullen, 2018). Depression is a common and treatable mental health condition that can cause various physical, emotional, and behavioural symptoms (Mullen, 2018).

What differential diagnosis should be considered? 

· Chronic fatigue syndrome: The patient's symptoms of fatigue, poor sleep quality, difficulty concentrating, and lack of energy could be consistent with chronic fatigue syndrome, a condition that causes persistent fatigue that is not relieved by rest.

· Tension headache: As mentioned earlier, the patient's headache symptoms could be consistent with a tension headache, a common type of headache that is characterized by diffuse, aching pain in the head and neck.

· Migraine headache: The patient's headache symptoms could also be consistent with a migraine headache, a type of headache that is characterized by intense, pulsing pain, often on one side of the head, and is often accompanied by other symptoms such as sensitivity to light, sound, and smell.

What test or screening tools should be considered to help identify the correct diagnosis? 

· Medical history and physical examination

· CBC

· PHQ-9

What treatment would you prescribe, and what is the rationale (consider psychopharmacology, diagnostics tests, referrals, psychotherapy, psychoeducation) 

Psychopharmacology: these include SSRIs or SNRIs to improve mood and reduce symptoms of depression.

Psychotherapy: CBT or IPT to help the patient identify and manage negative thought patterns, build coping skills, and address any underlying psychological or emotional issues contributing to their symptoms (National Institute of Mental Health 2018).

Psychoeducation: educate the patient about depression, chronic fatigue syndrome, tension headaches, and migraines, as well as strategies for managing symptoms and improving overall well-being.

What standard guidelines would you use to assess or treat this patient?

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Robert Alonso

13 hours ago, at 10:03 PM

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The patient does not have a history of serious medical or mental health difficulties, nor does he or she usually use any drugs. The patient appears to be suffering from a case of depression, based on the facts I have obtained. These symptoms may make it difficult for persons with severe depression to interact with others and carry out their jobs. Depression can manifest in several ways, including changes in weight and libido, overpowering feelings of guilt, and suicidal ideation. People occasionally consider terminating their lives by committing suicide, even in extraordinary circumstances. For a person to be diagnosed with a major depressive illness, at least five symptoms must be present, and they must have persisted for at least two weeks. When treating a depressed patient, a physician must determine if a combination of medication and psychotherapy is not only feasible but also readily available and affordable (Clarkin et al., 2019).

Both cognitive behavioural therapy and antidepressant medication can be beneficial in treating mild to severe depression. Most of the time, antidepressants are the treatment of choice since they are more effective than motivational interviewing. Antidepressants that block selective serotonin re-uptake include citalopram, escitalopram, fluoxetine, paroxetine, and sertraline (SSRIs). Unlike other antidepressants, SNRIs contain duloxetine, desvenlafaxine, and levomilnacipran in addition to venlafaxine, desvenlafaxine, and levomilnacipran (Cohen & DeRubeis, 2018). The two most used forms of antidepressants, SSRIs and SNRIs, have comparable response rates and can be taken alone to treat mild, moderate, and severe depression. There is little evidence to suggest that one of the conventional antidepressants is superior to the others for the treatment of depression. It is essential, while selecting a medication, to consider not just the patient's preferences but also the treatment's efficacy and track record of success with other patients (Clarkin et al., 2019).

 

 

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Ariel Lopez

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Summary of the Clinical Case 

           The patient visits the office with a headache and fatigue issues. She reports feeling tired and having difficulty getting sleep. She wakes up early and has a dull, aching, and generalized headache. She admits that these symptoms began 21 days ago and have worsened. She has lost interest in the activities she previously enjoyed (Jakobsen et al., 2020). She will not work due to fatigue and a challenge in focusing. She has no appetite and lost weight of 10 pounds last month.

The List of the Client's Issues

           There is a challenge in getting sufficient sleep; she has lost interest in previous activities, lost focus, missed work because of fatigue, is more concerned about her children and fears they might get lost, and have a headache.

Diagnosis to be Considered and Reasons 

           The potential condition is a major depressive disorder. She presents with six symptoms which have lasted for three weeks. The DSM-5 diagnosis of major depressive disorder requires at least five of the nine symptoms (Westhoff-Bleck et al., 2020). There must be the presence of depressed moods or lost interest in activities. Based on the scenario, the patient has lost interest in an activity, experienced changes in her weight and is not dieting, fatigue, decreased focus, retardation of the psychomotor, and insomnia.

Differential Diagnosis 

           The potential differential diagnoses are anxiety, bipolar disorder, borderline personality disorder, and adjustment disorder characterized by depressed mood.

Test or the Screening tool to Apply 

           The Beck Depression Inventory (BID) can screen depression conditions (Westhoff-Beck et al., 2020). It helps measure the behavioral manifestation and the severity of the condition.

Treatment to Propose 

           The suitable drug for treatment is escitalopram which is an SSRI. It has fewer side effects, well tolerated by the patient with no other medical issues.

The Standard Guideline for the Assessment or Treatment of the Patient 

           The standard guideline for the assessment and treatment involves the consideration of scientific proof, considering the benefits compared to harms, and the values and preferences of the clients (Jakobsen et al., 2020). There is also a need to consider the applicability of the evidence across demographic groupings and settings.

Obdelis Dominguez

14 hours ago, at 9:45 PM

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Case summary 

Patient is female, 28 years of age; married with two children. Chief complaint is headaches and fatigue (3 weeks old). No psychiatry or significant past medical history. Not on any chronic medication or drug and alcohol use. She takes OTC brufen for the headache spells.

Patient’s problems in order of priority (highest to least).

1. -Generalized dull aching headaches

2. -Fatigue and difficulty sleeping; resultsin concentration loss

3. -Unintentional ten-pound weight loss overthe previous month

4. -Loss of interest in most of her routineactivities including the enjoyable ones

5. -Truancy at work and crying spells

6. -Family dysfunction – she states that sheis ‘losing’ her children

The patient is most likely experiencing major depressive disorder (MDD). From her history summary, she presents with two major symptoms which have been described by the American Psychiatric Association (APA) in the DSM-5 as the key symptoms of MDD: depressed mood (crying spells) and interest loss in her routine activities. In addition to the two, the patient should have at least three others of the following symptoms almost daily for at least two subsequent weeks:

1. Unintentionalweight loss of at least 5% of their total weight in a month

2. Difficultysleeping or oversleeping

3. Exhaustion

4. Lossof concentration

5. Restlessness

6. Feelingworthless

7. Recurringsuicidal thoughts

The client presents with five of the symptoms (1, 2, 3, 4, and 6) which from her description, are causing her remarkable anguish in her daily life functioning. This diagnosis is also in consideration that she is not on any long term medication or substance use.

Differential diagnosis

1. -Irritable mood in mania – Medication orsubstance-induced depressive disorder

2. -Medical condition-related mood disorder – Sadness

 (APA DSM 5, 2013)

Screening tools 

Direct questioning reveals the symptoms. The Patient Health Questionnaire (PHQ)-2 and PHQ-9 are commonly used to screen for depression in adults. PHQ-2 is used at the first step and if positive, PHQ-9 is administered for diagnostic accuracy as it is more comprehensive (Siniscalchi et al., 2020). 

Treatment

Combination medication and psychotherapy are more effective than one of them (Bains & Abdijadid, 2022). All antidepressants have the same level of efficacy only that their side-effects vary. Mood stabilizers and antipsychotics are additionally used to counter the effects of antidepressants. Psychotherapy includes interpersonal and cognitive behavioral therapies. With p to four failed attempts at pharmacotherapy, the Food and Drug Agency has approved Vagal stimulation as an adjunctive therapy option (Bains & Abdijadid, 2022).

Standard guidelines of assessment 

1. Historytaking

2. Askidentification questions in line with the common mental health assessment. Takeinto account symptom severity, previous history, duration and progress ofillness and not merely symptom count.

3. Conducta risk assessment particularly for suicide

4. Administera screening tool for comprehensive diagnosis

5. (National Institute for Health and CareExcellence, 2022)

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Marta Garcia Diaz

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Clinical case

Summary of the Case:

A 28-year-old female is experiencing symptoms of headaches, fatigue, trouble sleeping, lack of interest in activities, difficulty concentrating, frequent crying spells, weight loss, and feeling like she is "losing" her children. She has no significant past medical or psychiatric history and takes ibuprofen for headaches. The symptoms suggest depression and anxiety and a thorough evaluation is needed to rule out underlying medical causes and referral to a mental health professional is recommended.

Prioritized list of patient's problems:

1. Depressionand anxiety

2. Headaches

3. Fatigue

4. Troublesleeping

5. Lackof interest in activities

6. Difficultyconcentrating

7. Frequentcrying spells

8. Weightloss.

Diagnosis: 

Based on the symptoms described, depression and anxiety should be considered as potential diagnoses for this patient. However, it is important to conduct a thorough evaluation, including a detailed history and physical examination, as well as laboratory tests, to rule out any underlying medical causes for the symptoms before making a definitive diagnosis. A referral to a mental health professional for a psychiatric evaluation and treatment is also recommended.

The rationale for this diagnosis is that the patient's symptoms of fatigue, trouble sleeping, lack of interest in activities, difficulty concentrating, frequent crying spells, and weight loss are consistent with depression. The patient's reported feelings of losing her children and worries about having "something bad" suggest potential anxiety. The symptoms have been present for about three weeks and have been worsening, supporting the possibility of a persistent mental health condition. However, it is important to rule out any underlying medical causes for the symptoms before making a definitive diagnosis.

Differential diagnosis:

In addition to depression and anxiety, other differential diagnoses that should be considered based on the patient's symptoms include:

1. Sleepdisturbance: sleep apnea, insomnia, restless leg syndrome

2. Chronicfatigue syndrome

3. Vitaminand mineral deficiencies: anemia, low B12 levels

4. Thyroiddisorders: hypothyroidism or hyperthyroidism

5. Chronicpain conditions: migraines, fibromyalgia

6. Substanceabuse: alcohol or drug use

7. Neurologicaldisorders: depression or anxiety can be symptoms of neurological conditionslike multiple sclerosis or Alzheimer's disease.

Tests and screening tools:

Different tests and screening tools can be considered to help identify the correct diagnosis for the patient in this clinical case. For example, the clinician can consider laboratory tests such as complete blood count, electrolyte levels, liver and kidney function tests, vitamin and mineral levels, and thyroid function tests to rule out any underlying medical causes for the symptoms. The Clinician can also use psychological evaluations and assessments such as the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder 7-item scale (GAD-7), and the Mini-International Neuropsychiatric Interview (MINI) to screen for depression and anxiety (Staples et al., 2019). Additionally, the clinician can conduct sleep studies such as polysomnography to evaluate for sleep-related disorders such as sleep apnea or insomnia and imaging studies such as MRI or CT scan to evaluate for any structural changes in the brain.

Treatment:

Based on the symptoms described and the likelihood of depression and anxiety one of the treatments that can be prescribed is a cognitive Behavioral Therapy (CBT) or Interpersonal Therapy (IPT) can be effective in treating depression and anxiety (Stamou et al., 2021). The clinician can also consider antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs) which can be effective in treating depression and anxiety symptoms (Lochmann & Richardson, 2019). Additionally, the clinician can include Lifestyle modifications such as Regular exercise, healthy diet, and stress management techniques because they can also help improve symptoms and overall well-being and establishing a regular sleep routine and avoiding caffeine and electronics before bedtime can help improve sleep quality.

Standard Guidelines:

The standard guidelines that could be used to assess and treat this patient include American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) for diagnostic criteria and classification of depression and anxiety, the National Institute for Health and Care Excellence (NICE) guidelines for the treatment of depression and anxiety in adults, the American College of Physicians (ACP) guidelines for the treatment of major depressive disorder and generalized anxiety disorder in adults and the American Academy of Sleep Medicine (AASM) guidelines for the evaluation and management of sleep-related disorders. These guidelines provide evidence-based recommendations for the assessment and treatment of depression, anxiety, and sleep-related disorders. They can help healthcare providers make informed decisions and provide high-quality care to their patients.

Idalmis Lopez

14 hours ago, at 9:42 PM

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Summary

A 28-year-old female came with different symptoms and there are several possible diagnoses including depression, sleep disturbance, migraines, chronic fatigue syndrome, and adjustment disorder. A comprehensive medical and psychiatric evaluation, including laboratory tests and imaging studies, is necessary to determine the underlying cause of the patient's symptoms and reach a definitive diagnosis.

Problems:

1. Fatigue and trouble sleeping

2. Headaches

3. Lack of interest in activities 

4. Difficulty concentrating

5. Worried about "losing" her children

6. Crying spells 

7. Weight loss of 10 pounds 

Diagnosis:

Based on the information provided, several possible diagnoses including Depression, fatigue, lack of interest in activities, difficulty concentrating, crying spells, weight loss, and concern about "losing" her children may be indicative of depression (Ghosh et al., 2021)

Rationale:

The patient's symptoms suggest several possible diagnoses, but a definitive diagnosis can only be made through further evaluation. 

Differential Diagnosis: 

Based on the information provided, the following differential diagnoses should be considered. For the assessment and treatment of depression, guidelines from "The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition" (Sarmiento, Lau, Processes, & Differences, 2020) and the National Institute for Health and Care Excellence (NICE) guidelines are used (Pincus et al., 2019).

Tests and screening Tools

Following tests and screening tools to help diagnose this patient using Physical examination, Blood tests, and screening tools for depression. Different standards like Health Questionnaire and the Beck inventory used for this purpose. Head CT or MRI, Sleep study, and Psychological evaluation can be performed (Pincus et al., 2019). 

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Treatment:

Antidepressants like fluoxetine belong to selective serotonin reuptake inhibitor can be described. A referral to a psychiatrist or a psychologist may be necessary interpersonal therapy or cognitive therapy, psycho-educations with monitoring and follow-up may be recommended (Pincus et al., 2019).. 

 

 

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Esdena Lacina

14 hours ago, at 9:38 PM

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A 28-year-old female states that she is troubled by fatigue and headache. She feels tired and cannot sleep. The patient does not have a significant psychiatric and medical history.

Summary of the Clinical case

 The 28-year-old female has headaches and fatigue. She always feels tired, and cannot sleep well. She often wakes up early. Her headache is dull, aching, and generalized. She has a lack of interest in her usual activities. The patient misses work because of her inability to concentrate and her fatigue. She experiences weight loss and appetite loss.

List of patient’s problems

1. Headaches

2. Weight loss

3. Fatigue

4. Loss of interest in normal activities

5. Loss of appetite

6. Sleep disturbances

7. Difficulty concentrating

Diagnosis

The diagnosis of major depressive disorder should be considered. The patient has a significant number of symptoms such as fatigue, reduced ability to concentrate or think, weight loss, and loss of interest. The diagnostic criteria require five or more symptoms during the two-week period (American Psychiatric Association 2013). These include decreased concentration, fatigue, insomnia, weight loss or gain, and loss of interest or pleasure. Those who suffer from the major depressive disorder are likely to experience diminished interest in many activities.

Differential diagnosis

Mild anxious distress should be considered. This should be considered because the patient has symptoms such as difficulty concentrating and fears that something awful could happen. The patient is worried about losing her children. She experiences crying spells and worries about something bad happening.

Test/screening tools

Tools such as the Beck Depression Inventory (BDI) could be used to identify a diagnosis. This inventory has self-report items that should be completed by individuals. Blood tests could be performed to determine if there are other health conditions (Otte 2019). Other tools such as GAD-7 could also be used for diagnosis.

Treatment

I would prescribe psychotherapy and medications such as SSRIs. SSRIs are generally safe. They include fluoxetine and paroxetine (Otte 2019). SSRIs can treat mild anxious stress and major depressive disorder. Cognitive therapy would be prescribed because it is effective in treating major depressive disorder.

Standard guidelines

The standard guidelines include participating in collaborative treatment planning with the patient, maintaining an effective therapeutic relationship, promoting

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Elizabeth Gonzalez

14 hours ago, at 9:37 PM

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Clinical Case Analysis

Case Summary 

The patient is aged 28 years and has reported cases of a dominant headache. In this case, a massive medical examination determines the best medication to be administered. 

List of patient’s problems

1. Reported headache

2. Uncontrolled Fatigue

3. Insomnia

Diagnostic to Consider 

If the condition is not managed, the patient will have a chronic related illness. In this case, the diagnosis to consider should address the three issues that have been outlined. The medication should be over the counter, and Excedrin can be used. It has acetaminophen and analgesics that increase sleep. Else naproxen sodium (Aleve) can be administered.

The rationale for the Diagnostic 

The combined medication has a share of caffeine, and sedative drugs have more ingredients that relieve pain fast and effectively. Anti-inflammatory agent reduces pain and gives a patient time to sleep. It's the best medication for a primary response or stage one treatment. 

Differential Diagnostic to be Considered 

 Based on the severity of the condition, as a medical doctor, I may take further tests to determine if a series of body processes would cause this condition. Some of the tests that would take include the following:

1. Erythrocyte sedimentation rate (ESR) scan.

2. Bloodpleasure

 In case the test states otherwise, the medication will change based on the findings attained.

Testing Tools and Screening

Haematology analyzers- this kit is used in measuring blood pressure and can be used to determine if it’s the source of the headache. 

 (ESR) scan – this test is used to show the red blood cells sink faster than the normality and has a negative effect. Besides that, it shows systemic and localized inflammation and infection, causing increased headaches. 

Treatment Prescription 

1. 250mg X3 times a day should be the naproxensodium (Aleve) and Excedrin prescription.

2. Thisshould be done after a test and results are attained.

Standard Guideline 

1. Themedication should be taken alongside plenty of water

2. Thepatient should avoid using alcohol during the treatment period

3. Ifthe condition does not improve, the patient should seek medical attention orreferral.

  

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DALIA SALGADO

14 hours ago, at 9:34 PM

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Clinical Case

Summary of Clinical Case:

A 28-year-old female presents with symptoms of headaches, fatigue, trouble sleeping, lack of interest in activities, difficulty concentrating, frequent crying spells, and weight loss of 10 pounds in the last month. She has no significant past medical or psychiatric history, takes ibuprofen for headaches, and denies using alcohol or drugs. She is married with two elementary school-age children.

List of Patient’s Problems and Prioritization:

1. Fatigue and trouble sleeping

2. Headaches

3. Lack of interest in activities

4. Difficulty concentrating

5. Frequent crying spells

6. Weight loss

Diagnosis to Consider:

1. Major Depressive Disorder

2. Generalized Anxiety Disorder

Rationale for Diagnosis:

The patient’s symptoms of fatigue, trouble sleeping, lack of interest in activities, difficulty concentrating, frequent crying spells, and weight loss are indicative of a mood disorder, specifically Major Depressive Disorder (Kumar et al., 2012). The patient’s worries about “losing” her children and having “something bad” also suggest the presence of anxiety, which can be diagnosed as Generalized Anxiety Disorder.

Differential Diagnosis to Consider:

1. Bipolar Disorder

2. Chronic Fatigue Syndrome

3. Thyroid Disorders

Test or Screening Tools to Consider:

1. Patient Health Questionnaire (PHQ-9)

2. Generalized Anxiety Disorder 7-item (GAD-7)scale

3. Blood test to rule out thyroid disorders

Treatment:

Antidepressant medication such as selective serotonin reuptake inhibitors (SSRIs) can be prescribed to treat the symptoms of Major Depressive Disorder (Strawn et al., 2022). During the therapy the patient should have a blood tests to rule out underlying medical causes. Addition the patient in this case should be Referred to a psychiatrist for further evaluation and treatment. A cognitive behavioral therapy (CBT) can also be helpful in addressing the patient's anxiety symptoms while education about the illness and its treatment can help the patient understand and manage their symptoms (Strawn et al., 2022).

Standard Guidelines to Assess or Treat the Patient:

1. American Psychiatric Association's Diagnosticand Statistical Manual of Mental Disorders, 5th Edition (DSM-5)

2. National Institute for Health and CareExcellence (NICE) guideline for the treatment of depression

3. World Health Organization's InternationalClassification of Diseases (ICD-11)

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Adalberto Valdes

14 hours ago, at 9:32 PM

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A female patient, aged 28 years, presents a history of dull, generalized headaches for three weeks. She reports the headache is associated with insomnia and lack of interest. The patient also reports significant weight loss associated with loss of appetite and fatigue. The patient says that the mentioned symptoms are getting worse. However, the patient has no significant past medical or psychiatric history or drug and substance abuse history.

           The above patient has major problems, including severe headaches, significant weight loss of more than 10 pounds, generalized body malaise, and lack of sleep. Depending on the presenting symptoms, migraine should be considered as the diagnosis.

           The rationale for choosing migraine as the diagnosis is because migraines present with severe headaches, which are generalized and dull. Migraine is triggered by insomnia and stress. Migraines are associated with difficulty concentrating, weight loss, and generalized body malaise.

           The differential diagnosis for migraine includes; exertional headaches, intracranial aneurysms, tension band headaches, and cluster headaches. The blood tests that can be done to aid in the diagnosis include erythrocyte sedimentation rate and a complete blood analysis. (Munjal et al., 2020). In this case, one can also do imaging tests like computed tomography and electroencephalography can also be done. 

           Treatment for migraines involves medications to relieve pain like non-steroidal anti-inflammatory drugs such as ibuprofen (Munjal et al., 2020). Lifestyle modifications like sleep hygiene and avoiding triggers like stress are crucial for managing migraines. Antipsychotic medications like amitriptyline are helpful in cases of migraine.

           The current guidelines for the treatment of migraines have three levels of recommendation. Level A contains antiepileptic's and beta blockers. Level B includes anti-depressants and beta blockers, while level C is as angiotensin receptor blocker (Munjal et al., 2020.

 

 

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Alianne Maria Liens

14 hours ago, at 9:28 PM

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Summary of the Clinical Case 

           The patient presents to the office with headache and fatigue problems. She reports to be constantly feeling tired and cannot sleep. She often wakes up early and reported having dull, aching, and generalized headaches. She reported that the symptoms started three weeks ago and have been worsening. She reported losing interest in her usual activities, even those she used to enjoy (American Psychological Association, 2019). She has not been at work due to fatigue and difficulty concentrating. She is becoming more concerned about her children since she has difficulty concentrating and has occasional crying spells. She reported a loss of appetite and 10 pounds in the last month. 

List the Patient's Issues and Prioritize them. 

           The patient lacks adequate sleep, lost interest in the previous activities she used to enjoy, had difficulty concentrating, and missed work due to fatigue; she is more concerned about her children and fears losing them, and reported a headache. 

The diagnosis to be considered and the reasons for the diagnosis 

           Based on the DMS-5 guideline on Diagnosis, the potential condition for the patient is a major depressive disorder. She presented six symptoms for the last three weeks. The diagnosis of this condition needs five out of the nine symptoms for two weeks. At least one of the symptoms, such as depressed mood or loss of interest, must be present (Ho et al., 2020). She has lost interest, reduced body weight when not dieting, insomnia, fatigue, reduced ability to concentrate, and psychomotor retardation. 

The differential Diagnosis to be Considered 

           The potential differential Diagnoses to be considered in this case are bipolar disorder, borderline personality disorder, adjustment disorder with depressed mood, and anxiety. 

The Test Screening Tools to be Considered to Help in the Identification of the Correct Diagnosis 

           The potential tool to use is the Beck Depression Inventory (BDI) for screening for depression and measuring the behavioral manifestation and severity (Ho et al., 2020). It is suitable for individuals of ages 13 to 80 years. Twenty-one self-reported items require individuals to complete using multiple choice response formats. 

The Treatment to Prescribe and the Reasons 

           The treatment of the condition involves SSRI since it has fewer side effects. It is also well tolerated by the client, with no medical problems. Therefore, medication like escitalopram will be prescribed. 

The Standard Guidelines to be used in the Assessment and Treatment of the Patient 

           The standard guideline for evaluating and treating patients with major depressive disorder involves a systematic review of the scientific evidence, weighing the benefits and possible harms of the interventions, consideration of the patient's preferences and values, and the applicability of the evidence across demographic groups and settings.

  

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Alberto Gutierrez Lopez

14 hours ago, at 9:27 PM

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Summary of the Clinical Case

A 28-year-old female presents to the office with symptoms of headaches, fatigue, difficulty sleeping, lack of interest in usual activities, difficulty concentrating, crying spells, loss of appetite and weight loss of 10 pounds in the past month. She has no significant past medical or psychiatric history and takes ibuprofen for headaches. The patient denies alcohol or drug use. She is married and has two school-age children.

List of problems and prioritization

1. Headachesand fatigue

2. Difficultysleeping

3. Lackof interest in usual activities

4. Inabilityto concentrate

5. Frequentcrying spells

6. Lossof appetite and weight loss

Diagnosis

The primary diagnosis that should be considered is Major Depressive Disorder (MDD). MDD is a common and serious medical illness that negatively affects how the patient feels, the way they think, and how they act. The symptoms presented by the patient such as loss of interest in usual activities, difficulty concentrating, and frequent crying spells, are all commonly seen in patients with MDD (Proudman et al., 2021). Additionally, the patient's weight loss, fatigue and lack of appetite are consistent with physical symptoms often seen in patients with depression.

Differential diagnosis

The differential diagnosis to consider includes Generalized Anxiety Disorder (GAD), Adjustment Disorder, and Chronic Fatigue Syndrome (CFS). GAD is characterized by excessive anxiety and worry about multiple events or activities, while Adjustment Disorder is a response to a specific stressor that results in significant distress or functional impairment (Proudman et al., 2021). CFS is a condition characterized by extreme fatigue that is not improved by rest and may be accompanied by other symptoms such as headaches, difficulty sleeping, and muscle and joint pain.

Test and Screening Tools to Consider

In order to help reach an accurate diagnosis, it is important to run a number of tests and screening tools. Screening tools such as the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7) can be used to help assess for depression and anxiety. A physical exam can be done to rule out any underlying physical conditions that may be causing the symptoms. Laboratory tests such as a complete blood count, thyroid function tests, and urine drug screen can also be done.

Treatment

It typically includes a combination of pharmacotherapy, psychotherapy, and psychoeducation. Antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), can be prescribed to help reduce symptoms of depression (Karrouri et al., 2021). Psychotherapy, such as cognitive behavioral therapy (CBT) or interpersonal therapy (IPT), can also be effective in treating MDD by helping the patient to identify and modify negative thought patterns and behaviors. Psychoeducation can help the patient understand the nature of depression and develop coping strategies to manage their symptoms.

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