Psychiatric Interventions for Teaching: Depression – Case Study Analysis

 

Psychiatric Interventions for Teaching: Depression – Case Study Analysis
Introduction:
Depression is a widespread mental health condition that affects millions of people worldwide. In the case study video “Psychiatric Interventions for Teaching: Depression,” a patient’s symptoms and problems are presented to provide insight into the complexities of treating depression. This essay aims to identify the target symptoms and problems, discuss additional subjective and objective information to gather, prioritize psychiatric symptoms for treatment, recommend a suitable medication choice, address safety concerns, and determine appropriate follow-up for the patient.

Target Symptoms/Problems:
The target symptoms/problems observed in the case study are as follows:

Persistent sadness and low mood
Loss of interest or pleasure in activities
Feelings of worthlessness or excessive guilt
Fatigue and lack of energy
Difficulty concentrating and making decisions
Changes in appetite and weight
Insomnia or excessive sleeping
Recurrent thoughts of death or suicide
Additional Subjective and Objective Information:
To gather a comprehensive understanding of the patient’s condition, it is crucial to obtain additional subjective and objective information, including:

Detailed medical history, including any previous depressive episodes or psychiatric diagnoses
Family history of mental health conditions
Duration and severity of symptoms
Any recent life events or stressors that may have triggered or worsened the depressive episode
Evaluation of the patient’s social support system
Assessment of any comorbid physical illnesses or medications that may contribute to depression symptoms
Evaluation of suicidal ideation, intent, and plan
Assessment of the patient’s overall functioning and quality of life
Treatment Priority:
In this case, the treatment priority should be given to the following psychiatric symptoms:

Suicidal ideation and intent: Given the patient’s recurrent thoughts of death and suicide, immediate attention should be given to ensure the patient’s safety.
Loss of interest and pleasure: Addressing anhedonia is vital to improve the patient’s motivation and engagement in daily activities.
Fatigue and lack of energy: Addressing these symptoms would enhance the patient’s overall functioning and quality of life.
Medication Choice:
A suitable medication choice for this case would be Sertraline at a starting dose of 50 mg per day.

Rationale:
Sertraline is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for depression due to its efficacy, tolerability, and safety profile. The mechanism of action involves inhibiting the reuptake of serotonin, leading to increased serotonin levels in the brain, which helps alleviate depressive symptoms.

Laboratory Testing/Monitoring:
When prescribing Sertraline, it is important to consider the following laboratory tests/monitoring:

Baseline liver function tests (LFTs) to assess hepatic function.
Baseline complete blood count (CBC) to monitor for any blood abnormalities.
Regular monitoring of liver function tests (LFTs) during the initial weeks of treatment, especially in patients with pre-existing liver conditions.
Contraindications/Safety Issues:
Some contraindications and safety issues associated with Sertraline include:

Hypersensitivity to Sertraline or any other SSRI.
Concurrent use with monoamine oxidase inhibitors (MAOIs) or within 14 days after discontinuing MAOIs.
Increased risk of suicidal ideation, especially in young adults or during the initial weeks of treatment.
Close monitoring for serotonin syndrome if used concurrently with other serotonergic medications.
Safety Risk Assessment:
The safety concerns associated with this case include:

Risk of suicide: Given the patient’s recurrent thoughts of death and suicide, immediate interventions are necessary to ensure patient safety.
Monitoring for adverse effects: Regular follow-up appointments should be scheduled to monitor medication effectiveness, side effects, and any emergent safety concerns.
Follow-up:
The patient should be followed up according to the severity of their condition. In this case, it is recommended to follow up with the patient within one week to assess their response to treatment, monitor for adverse effects, evaluate suicidal ideation, and adjust medication dosage if necessary.

References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
National Institute for Health and Care Excellence (NICE). (2020). Depression in adults: recognition and management. Retrieved from https://www.nice.org.uk/guidance/cg90