Posted: May 19th, 2023

Part 1: Differential Diagnoses

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Use the case study below to answer these two parts of the assigment.
Part 1
This assigment has two parts to it. Ace my homework – Write what the 3 differential diagnoses are 150-to-200-word count. Taking into account the patient case study below and what are the criteria base on the DSM TR 5.
Differential diagnosis
1) Major Depressive Disorder (MDD)
2) Generalized anxiety disorder GAD
3) Post traumatic stress syndrome PTSD
Case study:
CC (chief complaint): “I have been feeling ashamed and worthless”
HPI: BD is a 38 y/o Caucasian male who presented to the outpatient services for a psychiatric evaluation for possible outpatient CBT. According to the patient, he received six weeks of CBT in this facility two years ago with positive results. The patient reported that it seems he divorced his wife for five years. He relocated to Chicago for a new job and to start a new life. The patient also reports having difficulty coming to terms with his previous attempt to commit suicide before his brother’s wedding. According to the patient, seems moving to Chicago two years ago, and his depression has gotten worst; he has developed anxiety and is finding it very difficult to gain control of his life. The patient reported an increase in ETOH use. BD is currently being treated with Sertraline 200 mg po daily, Buspirone 15mg PO TID PRN for anxiety, and Trazadone 150mg PO at bedtime for insomnia. According to BD, he has sought the help of a few different outpatient services for CBT therapy in Chicago, but none have been effective, like the one in the state of GA, where two years ago, he received CBT for six weeks. The patient took a leave and absence from his job in Chicago to return to Atlanta, GA, to seek the help of outpatient services, which he has found effective in the past.
Part 2
Reflection notes: Reflection notes: What would you do differently in a similar patient evaluation? Reflect on one social determinant of health according to the Healthy People 2030 (you will need to research) as applied to this case in the realm of psychiatry and mental health. As a future advanced provider, what are one health promotion activity and one patient education consideration for this patient for improving health disparities and inequities in the realm of psychiatry and mental health? Demonstrate your critical thinking.

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Part 1: Differential Diagnoses

Based on the provided case study and the criteria from the DSM-5, three possible differential diagnoses for the patient could be:

Major Depressive Disorder (MDD): The patient’s chief complaint of feeling ashamed and worthless, along with symptoms of depression such as difficulty gaining control of life, worsening depression since moving to Chicago, and increased alcohol use, are indicative of MDD. The patient’s previous suicide attempt also suggests a history of depressive episodes.

Generalized Anxiety Disorder (GAD): The patient reports developing anxiety and finding it difficult to gain control of life. This, along with the prescribed medication Buspirone for anxiety, indicates the presence of GAD. The patient’s relocation and life changes may have triggered persistent and excessive worry and fear.

Post-Traumatic Stress Disorder (PTSD): The patient’s difficulty coming to terms with a previous suicide attempt before his brother’s wedding, along with symptoms of anxiety, depression, and insomnia, may point towards PTSD. The trauma of the suicide attempt and its impact on the patient’s life could be contributing to his current mental health issues.

It is important to conduct a comprehensive evaluation and consider these potential diagnoses while also ruling out other possible conditions to arrive at an accurate diagnosis for the patient.

Part 2: Reflection Notes

In a similar patient evaluation, I would ensure the following improvements:

Establishing a Collaborative Approach: I would involve the patient in shared decision-making and treatment planning. Collaborating with the patient can help create a therapeutic alliance, enhance treatment adherence, and improve outcomes.
Social Determinant of Health: Employment

According to Healthy People 2030, employment is a social determinant of health that influences mental health outcomes. In this case, the patient’s job relocation and subsequent difficulties in adjusting to a new environment and life may have contributed to his mental health issues. Unemployment or unsatisfactory employment can have negative impacts on mental well-being.

Health Promotion Activity: Supportive Workplace Environment

To address the social determinant of employment and promote mental health, one health promotion activity would be to advocate for a supportive workplace environment. Encouraging employers to provide mental health resources, flexible work arrangements, and fostering a positive and inclusive workplace culture can promote psychological well-being among employees.

Patient Education Consideration: Community Mental Health Resources

To improve health disparities and inequities in the realm of psychiatry and mental health, it is crucial to educate the patient about community mental health resources. Providing information about local mental health clinics, support groups, and helplines can empower the patient to seek appropriate and accessible mental health support, regardless of their socio-economic background.

By addressing the social determinant of employment and implementing health promotion activities and patient education, healthcare providers can contribute to reducing mental health disparities and promoting equitable access to mental health services.

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