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Therapy with Older Adults
The primary diagnosis for this client is major depressive disorder (MDD). It is a DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Ed.) diagnosis assigned to individuals who feel down and have lost interest in activities they previously enjoyed. This depressed feeling must occur daily for at least 2 weeks for a diagnosis to be given. Those who suffer from depression experience persistent feelings of sadness and hopelessness and lose interest in activities they once enjoyed. Aside from the emotional problems caused by depression, individuals can also present with a physical symptom such as chronic pain or digestive issues.
DSM-V Coding for MDD
MDD diagnosed as having either single or recurrent episodes. The severity level, such as mild, moderate, severe and with psychotic features, is also specified to note the unique aspects of the course of the disorder. The coding for single episode include 296.21 (F32.0) Mild 296.22 (F32.0) Moderate, 296.23 (F32.2) Severe, 296.24 (F32.0) In Partial Remission, 296.26 In full Remission, 296.20 (F32.9) Unspecified. The coding for recurrent episode include 296.31 (F33.0) Mild, 296.32 (F33.1) Moderate, 296.33 (F33.2) Severe, 296.34 (F33.3) With Psychotic Features, 296.35 (F33.41) In Partial Remission, 296.36 (F33.42) In Full Remission, 296.30 (F33.9) Unspecified (American Psychiatric Association, 2013).
The rationale for the Diagnosis
The DSM-5 outlines the following criterion to make a diagnosis of depression. The individual must be experiencing five or more symptoms during the same 2-week period, and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure (American Psychiatric Association, 2013). Some of these symptoms include feelings of sadness and hopelessness, loss of interest or pleasure in activities, Loss of weight or weight gain, difficulties sleeping or excessive sleepiness, noticeable restlessness or slowness, lack of energy, troubles concentrating and indecisiveness, feeling of worthless and excessive guilt, continued thoughts of wanting to die (Wheeler, 2014). The presence of anxiety in patients may affect prognosis, treatment options, and the patient’s response to clinicians
Based on the symptoms presented in the case study, the client met the criteria for DSM-5 in several ways. First, the client reported that he experienced symptoms of depression and anxiety for few months including sleeping problems, feeling tired all the time, moving in slow motion, and stopped attending the volunteer job at the nursing home. Some of the risk factors associated with the depression reported by the client include the loose of his father who he mentions as the primary source of support and his diagnoses for prostate cancer this year (American Psychiatric Association, 2013). Besides, conditions such as hypertension and hyperlipidemia are associated with some level of depression. Depression is also considered as an inherited condition, and since mother had the condition, there is a possibility he has the condition too (Wheeler, 2014).
Diagnostic tests and physical exam are the two primary methods used to confirm the diagnosis of clinical depression. The main goal of a physical exam is usually to rule out other medical cause for depression (Bilello, 2016). When performing the physical exam, the clinician may focus primarily on the neurological and endocrine system and try to identify any major health concerns that may be contributing to symptoms of depression. For instance, hypothyroidism caused by an underactive thyroid gland is the most common medical condition associated with depressive symptoms. Lab test such as blood tests is also used to check for a medical condition that may cause depressive symptoms such as thyroid, anemia, or possibly other hormones.
Differential diagnosisBipolar disorders- These mood disorders include mood swings that range from highs (mania) to lows (depression). It’s sometimes difficult to distinguish between bipolar disorder and depression
Cyclothymic disorder- Cyclothymic disorder involves highs and lows that are milder than those of bipolar disorder.
Persistent depressive disorder- sometimes called dysthymia, this is a less severe but more chronic form of depression. While it’s usually not disabling, the persistent depressive disorder can prevent you from functioning normally in your daily routine and from living life to its fullest(Portaccio, 2016).
Treatment Strategies for MDD
A wide range of effective treatments is available for major depressive disorder. Medication alone and brief psychotherapy (e.g., Cognitive-behavioral therapy, interpersonal therapy) alone can relieve depressive symptoms. There is also empirical support for the ability of brief psychotherapy (CBT) to prevent relapse. A study comparing the outcome rates of 7 different psychotherapies found that there was no difference in the success rate of the different psychotherapies. However, the dropout rate for cognitive-behaviour therapy was significantly higher than with the other therapies ( will get it few hours before your set deadline. Fill in all the assignment paper details that are required in the order form with the standard information being the page count, deadline, academic level and type of paper. It is advisable to have this information at hand so that you can quickly fill in the necessary information needed in the form for the essay writer to be immediately assigned to your writing project. Make payment for the custom essay order to enable us to assign a suitable writer to your order. Payments are made through Paypal on a secured billing page. Finally, sit back and relax..
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