SOCW 6090

 

Learning Resources

Required Readings

Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.
Chapter 11, “Diagnosing Depression and Mania” (pp. 129–166)
Classroom Productions. (Producer). (2015). Depressive disorders [Video]. Walden University. 
American Psychiatric Association. (2013). Bipolar and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm03
Jain, R., Maletic, V., & McIntyre, R. S. (2017). Diagnosing and treating patients with mixed features. Journal of Clinical Psychiatry, 78(8), 1091–1102. doi:10.4088/JCP.su17009ah1c
Diagnosing and Treating Patients with Mixed Features by Jain, R.; Maletic, V.; McIntyre, R., in Journal of Clinical Psychiatry, Vol. 78/Issue 8. Copyright 2017 by Physicians Postgraduate Press. Reprinted by permission of Physicians Postgraduate Press via the Copyright Clearance Center.
Walton, Q. L., & Payne, J. S. (2016). Missing the mark: Cultural expressions of depressive symptoms among African-American women and men. Social Work in Mental Health, 14(6), 637–657. doi:10.1080/15332985.2015.1133470

Required Media

TED Conferences, LLC (Producer). (2013). Depression, the secret we share [Video file]. Retrieved from https://www.ted.com/talks/andrew_solomon_depression_the_secret_we_share
TEDx Talks. (2013a, May 23). Depression is a disease of civilization: Stephen Ilardi at TedxEmory [Video file]. Retrieved from https://youtu.be/drv3BP0Fdi8

Optional Resources

American Psychiatric Association. (2013). Assessment measures. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.AssessmentMeasures
Santiago-Rivera, A. L., Benson-Flórez, G., Santos, M. M., & Lopez, M. (2015). Latinos and depression: Measurement issues and assessment. In K. F. Geisinger (Ed.), Psychological testing of Hispanics: Clinical, cultural, and intellectual issues (2nd ed., pp. 255–271). Washington, DC: American Psychological Association. doi:10.1037/14668-014
Thase, M. E., Weisler, R. H., Trivedi, M. H., & Manning, J. S. (2017). Utilizing the DSM-5 Anxious Distress specifier to develop treatment strategies for patients with major depressive disorder. Journal of Clinical Psychiatry, 78(9), 1351–1362. doi:10.4088/JCP.ot17015ah1
Utilizing the DSM-5 Anxious Distress Specifier to Develop Treatment Strategies for Patients with Major Depressive Disorder by Thase, M.; Weisler, R.; Trivedi, M.; Manning, J., in Journal of Clinical Psychiatry, Vol. 78/Issue 9. Copyright 2017 by Physicians Postgraduate Press. Reprinted by permission of Physicians Postgraduate Press via the Copyright Clearance Center.
Document: Suggested Further Reading for SOCW 6090 (PDF)

Note: This is the same document introduced in Week 1.

Discussion: Applying Differential Diagnosis to Depressive and Bipolar Disorders

What is it truly like to have a mental illness? By considering clients’ lived experiences, a social worker becomes more empathetic and therefore better equipped to treat them. In this Discussion, you analyze a case study focused on a depressive disorder or bipolar disorder using the steps of differential diagnosis.

To prepare: View the TED Talk “Depression, the Secret We Share” (TED Conferences, LLC, 2013) and compare the description of Andrew Solomon’s symptoms to the criteria for depressive disorders in the DSM-5. Next review the steps in diagnosis detailed in the Morrison (2014) reading, and then read the case provided by your instructor for this week’s Discussion, considering the client against the various DSM-5 criteria for depressive disorders and bipolar disorders.

By Day 3

Post a 300- to 500-word response in which you address the following:

• Provide the full DSM-5 diagnosis for the client. For any diagnosis that you choose, be sure to concisely explain how the client fits that diagnostic criteria. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, medical needs, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
• Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
• Recommend a specific evidence-based measurement instrument to validate the diagnosis and assess outcomes of treatment.
• Describe your treatment recommendations, including the type of treatment modality and whether or not you would refer the client to a medical provider for psychotropic medications.

CASEPRESENTATION – KATIE

 

Intake Date: August 2020

 

IDENTIFYING/DEMOGRAPHIC DATA: Katie is a 21yr old single woman from Greece. Katie moved to the United States 3 years ago with her parents and two siblings, a brother and sister, both older.

      

CHIEF COMPLAINT/PRESENTING PROBLEM: Katie was referred to the outpatient department of a community hospital after a medical examination revealed that most of her physical symptoms did not have a physical cause.

 

HISTORY OF PRESENT ILLNESS: Katie complained about weight loss, headaches, menstrual irregularity, low energy, and high anxiety. The physician referred her to a clinical social worker in the hospital. Katie told the social worker that she felt confused and sad; she did not know what to do with her life. She has felt down much of her life, but now it is interfering with her ability to function in daily life. About a month ago, she says she experienced a strange period of anxiety in the middle of the night. She awoke suddenly at 3 am feeling absolute terror. Her heart was beating so hard, she was afraid she would have a heart attack. Her surroundings felt odd and unfamiliar. She felt like running away and would only feel safe if she could get back to her parents. She could not stand to stay in the apartment, so she drove around town until she calmed down. Since then, she has developed a fear of being alone in the apartment and is thinking of getting another job so that she can work a late shift and does not have to come home so early. It frightened her that she had another episode last night with the same chilly sensation.

PAST PSYCHIATRIC HISTORY: Katie denies any past therapy. She has never been an overly excited person. Katie has always felt there was a big burden on her shoulder. Her mood has always been rather down.

SUBSTANCE USE HISTORY: Katie reports drinking socially and denies any drug use.

PAST MEDICAL HISTORY: Katie went to her family doctor due to her weight loss and other physical symptoms that she has been experiencing. She is convinced that there is something going on, but the doctors cannot find any physical symptoms.

 

FAMILY HISTORY INCLUDING MEDICAL AND PSYCHIATRIC:

When asked further about her family of origin, she said that she was an “abused child.” She said that her father used to “kick me around while my mother stood and watched.” She said that her brother and sister were also abused, but she was the only one who used to fight back with her father, even though she was small. She said that her brother and sister have managed to forgive her parents, but she cannot. Nevertheless, it still bothers her that they ignore her outside of work.

 

CURRENT FAMILY ISSUES AND DYNAMICS (OPTIONAL): Katie lives with Max, who works as a long-haul truck driver. Max is 10 years older than she and has a 7-year-old son from a previous marriage who lives with his mother. Katie met Max at her family’s diner where she works as a waitress. Since moving in with Max 2 years ago, Katie’s physical symptoms have become more and more evident. When asked to talk further about the circumstances surrounding her moving in with Max, Katie said that “In moving in with Max, I lost my parents.” When asked to explain, she said that her parents consider her “loose” and have cut off a lot of communication with her. Their only discussions are in the diner about work. Katie does, however, keep in close contact with her brother and sister, who live together in an apartment in town. Katie said that even though she and Max have two incomes, they are struggling financially. Max has to pay child support. She does not earn very much.

Katie said that she loves Max, moving in with him has not been as wonderful as she had anticipated. For one thing, he is out of town a great deal, so she is alone in their apartment much of the time. Because she is living with him, she does not feel comfortable running around with her old crowd. She thinks all she does is go to work, while he comes home and watches TV. Last month, however, Katie did go out with one of the waiters at the diner. It started out as a casual invitation on Rick’s part that they go out for a drink, but she ended up sleeping with him. Even though Max was out of town, she did not spend the whole night with Rick. The next morning she felt terrible qualms of guilt. She sees Rick every day at work and they continue to be friends, but it disturbs her greatly to be around him.

MENTAL STATUS EXAM: Katie presents with a depressed mood. She becomes teary eyed periodically when describing how bad she feels. There are no reported delusions or hallucinations. She denies suicidal and homicidal ideation. When asked what her goals for herself were, she said that she always wanted to make something of her life, but she feels trapped. She said that a “high school diploma doesn’t get you very far;” but she can’t afford to go to college. She would like to get married someday but she does not feel mature enough to do so in the near future. She has thoughts about getting into work involving animals, which she loves, but does not know how to start. Her immediate goal she said was to feel “unconfused” and not so afraid.