Depression Essay Assignment Paper

The client is an 8-year-old African American male who arrives at the ER with his mother. He is exhibiting signs of depression.

Client complained of feeling “sad”

Mother reports that teacher said child is withdrawn from peers in class

Mother notes decreased appetite and occasional periods of irritation

Client reached all developmental landmarks at appropriate ages

Physical exam unremarkable

Laboratory studies WNL.

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Child referred to psychiatry for evaluation

MENTAL STATUS EXAM

Alert & oriented X 3, speech clear, coherent, goal directed, spontaneous. Self-reported mood is “sad”. Affect somewhat blunted, but child smiled appropriately at various points throughout the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. Judgment and insight appear to be age-appropriate. He is not endorsing active suicidal ideation, but does admit that he often thinks about himself being dead and what it would be like to be dead.

You administer the Children’s Depression Rating Scale, obtaining a score of 30 (indicating significant depression)

Decision Point One

Select what you should do:

a.Begin Zoloft 25 mg orally daily

b.Begin Paxil 10 mg orally daily

c.Begin Wellbutrin 75 mg orally BID

Decision Point One A- Begin Zoloft 25 mg orally daily. Depression Essay Sample

RESULTS OF DECISION POINT ONE

Client returns to clinic in four weeks

No change in depressive symptoms at all

Decision Point Two

Select what you should do next:

a.Increase dose to 37.5 mg orally daily

b.Increase dose to 50 mg orally daily

c.Change to Prozac 10 mg orally daily

Decision Point Two- Increase dose to 50 mg orally daily

RESULTS OF DECISION POINT TWO

Client returns to clinic in four weeks

Depressive symptoms decrease by 50%. Cleint tolerating well

Decision Point Three

Select what you should do next:

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a.Maintain current dose

b.Increase to 75 mg orally daily

c.Change to a SNRI. Depression Essay Sample

RESULTS OF DECISION POINT THREE

Guidance to Student

At this point, sufficient symptom reduction has been achieved. This is considered a “response” to therapy. Can continue with current dose for additional 4 week to see if any further reductions in depressive symptoms are noted. An increase in dose may be warranted since this is not “full” remission- Discuss pros/cons of increasing drug dose with client at this time and empower the client to be part of the decision. There is no indication that the drug therapy should be changed to an SNRI at this point as the client is clearly responding to this therapy.

Introduction to the case (1 page)

Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient. Depression Essay Sample

Decision #1 (1 page)

Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Depression Essay Sample

Decision #3 (1 page)

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature. Depression Essay Sample

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Depression

Introduction to the Case

The case study involves an 8-year-old African American boy who presented to the ER with his mother. The client manifested signs of depression such as feeling sad; being withdrawn from peers in class; reduced appetite and sporadic periods of irritation. The client has reached all developmental landmarks at proper ages and the findings from the physical exam were normal. The client was referred to psychiatry for further assessment. The mental status exam (MSE) indicated that the client was alert and oriented to time, event, and place; his speech was clear and coherent, and he was also goal-directed and spontaneous. His self-reported mood was “sad” and he smiled normally several times during the clinical interview. The client’s affect was somewhat blunted. He denies any auditory or visual hallucinations. The assessment did not indicate any paranoid or delusional thoughtprocess and his insight and judgment appeared appropriate for his age. He denied any suicidal ideation but admitted that he often thinks of himself being dead and imagines what it would like to be dead. The client was administered with the Children’s Depression Rating Scale and scored 30, indicating significant depression. The client was thus diagnosed with depression. This assignment will discuss three treatment decisions for the client. The client is a pediatric patient and thus it will be good to select the medication with a good safety profile and few side effects/metabolic effects. The paper will also discuss the ethical issues likely to influence and affect the client’s treatment plan.

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