In acute care settings, patients with psychosocial health conditions may present with a variety of complex symptoms that require comprehensive assessment

In acute care settings, patients with psychosocial health conditions may present with a variety of complex symptoms that require comprehensive assessment. The results from this assessment are crucial to developing a diagnosis and creating an individualized treatment plan for a patient. For this Discussion, you focus on the assessment as you consider case studies of patients with psychosocial health conditions. You determine what history should be collected from the patients as well as what physical exams and diagnostic tests should be conducted, and you formulate a differential diagnosis with several possible conditions.

To prepare:

• Review this week’s media in Assessment of Psychosocial Health Conditions and select one of the three case studies.

• With the case study you selected in mind, reflect on the patient information provided.
• Think about the health history you would need to collect from the patient.
• Consider what physical exams and diagnostic tests would be appropriate to help you gather more information about the patient’s condition. Reflect on how results might be used to make a diagnosis.
• Identify at least five possible conditions to consider in a differential diagnosis for the patient.
• By Day 3
• Post a description of the health history you would need to collect from the patient in the case study you selected. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five possible conditions for the patient’s differential diagnosis and justify why you selected each.

ANSWER

Case Study Review

The case study selected for review is that of Eileen Brown. The problems that Brown reported are anxiety, being moody, feeling depressed, and feeling washed out. She further states that the issues began three years ago and are worsening. Brown does not have a drug problem, and she points to family issues as the cause of her problems.

Further health history that should be collected from the patient is whether she has ever been diagnosed with thyroid problems, vitamin D deficiency, or calcium deficiency. Thyroid problems have been linked to depression (Ittermann Et al., 2015). Calcium and vitamin D deficient patients have also been found to struggle with depression (Milaneschi Et al., 2014). A physical condition may be the cause of Brown’s psychological problems.

Physical tests that would help gather more information about the patients are a blood test, MRI scan, Electroencephalogram (EEG), and Electrocardiogram (ECG) test. A blood test would help check levels of calcium, vitamin D, and hormones levels and thyroid issues (WebMD, 2018). MRI and EEG test would help determine whether Brown has a severe brain illness and electrical activity in her brain (Murray Et al., 2016). ECG would help decide whether or not she has developed heart problems. Depression diagnosis tools that I would administer are the Patient Health Questionnaire-9 (PHQ-9) and the Beck Depression Inventory (BDI) (WebMD, 2018).

Five possible conditions that the patients could be suffering from are situational depression, generalized anxiety disorder (GAD), chronic stress, vitamin D deficiency, or brain illness. Depression, GAD, and chronic stress have very similar symptoms, and it is critical to differentiate between the three (Khoury Et al., 2015). Vitamin D deficiency or brain illness could be the cause of Brown’s problems as the two have been linked to such issues.             

References

Ittermann, T., Völzke, H., Baumeister, S. E., Appel, K., & Grabe, H. J. (2015). Diagnosed thyroid disorders are associated with depression and anxiety. Social psychiatry and psychiatric epidemiology, 50(9), 1417-1425.

Khoury, B., Sharma, M., Rush, S. E., & Fournier, C. (2015). Mindfulness-based stress reduction for healthy individuals: A meta-analysis. Journal of psychosomatic research, 78(6), 519-528.

Milaneschi, Y., Hoogendijk, W., Lips, P. T. A. M., Heijboer, A. C., Schoevers, R., Van Hemert, A. M., … & Penninx, B. W. J. H. (2014). The association between low vitamin D and depressive disorders. Molecular psychiatry, 19(4), 444.

Murray, A., McNeil, C., Salarirad, S., Deary, I., Phillips, L., Whalley, L., & Staff, R. (2016). Brain hyperintensity location determines outcome in the triad of impaired cognition, physical health and depressive symptoms: A cohort study in late life. Archives of gerontology and geriatrics, 63, 49-54.

WebMD. (2018). Tests Used to Diagnose Depression. Retrieved from