Assessing, Diagnosing and Treating Adults with Mood Disorders

It is important for the PMHNP to have a comprehensive understanding of mood disorders in order to assess and accurately formulate a diagnosis and treatment plan for patients presenting with these disorders. Mood disorders may be diagnosed when a patient’s emotional state meets the diagnostic criteria for severity, functional impact, and length of time. Those with a mood disorder may find that their emotions interfere with work, relationships, or other parts of their lives that impact daily functioning. Mood disorders may also lead to substance abuse or suicidal thoughts or behaviors, and although they are not likely to go away on their own, they can be managed with an effective treatment plan and understanding of how to manage symptoms.
In this Assignment you will assess, diagnose, and devise a treatment plan for a patient in a case study who is presenting with a mood disorder.

RESOURCES
Required Readings
• Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.
o Chapter 6, “Bipolar Disorders”
o Chapter 2, “Neurodevelopmental Disorders and Other Childhood Disorders”
 Section 2.9, “Depressive Disorders and Suicide in Children and Adolescents” (pp. 174-180)
 Section 2.10, “Early-Onset Bipolar Disorder” (pp. 181-184)
o Chapter 7, “Depressive Disorders”
o Chapter 21, “Psychopharmacology”
o Chapter 22, “Other Somatic Therapies”

• Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.
o Chapter 11, “Mood Disorders”

Required Media
• CrashCourse. (2014, September 8). Depressive and bipolar disorders: Crash course psychology #30Links to an external site. [Video]. YouTube. https://youtu.be/ZwMlHkWKDwM https://www.youtube.com/watch?v=ZwMlHkWKDwM&t=1sLinks to an external site.
• Walden University. (2021). Case study: Petunia Park. Walden University Blackboard. https://waldenu.instructure.com
• Medication Review
Depression Premenstrual dysphoric disorder Seasonal affective disorder (MDD with Seasonal Variation)
agomelatine
amitriptyline
amoxapine
aripiprazole
(adjunct)
brexpiprazole (adjunct)bupropion
citalopram
clomipramine
cyamemazine
desipramine
desvenlafaxine
dothiepindoxepin
duloxetine
escitalopram
fluoxetine
fluvoxamine
iloperidone
imipramine
isocarboxazid
ketamine
lithium (adjunct)
l-methylfolate (adjunct)

lofepramine

maprotiline
mianserin
milnacipran
mirtazapine
moclobemide
nefazodone
nortriptyline
paroxetine
phenelzine
protriptyline quetiapine (adjunct)
reboxetine
selegiline
sertindole
sertraline
sulpiride
tianeptine
tranylcypromine
trazodone
trimipramine
venlafaxine
vilazodone
vortioxetine
citalopram
desvenlafaxine
duloxetin
eescitalopram
fluoxetin
eparoxetine
pepexev
sarafe,
sertraline
venlafaxine Bupropion HCL extended-release
•
Bipolar depression Bipolar disorder (mixed Mania/Depression Bipolar maintenance Mania
lithium (used with lurasidone)
lurasidone
olanzapine-fluoxetine combination (symbyax)
quetiapine
valproate (divalproex) (used with lurasidone) aripiprazole
asenapine
carbamazepine olanzapine
ziprasidone
aripiprazole

lamotrigine
lithium
olanzapine aripiprazole
asenapine
carbamazepine
lithium
olanzapine
quetiapine
risperidone

valproate (divalproex)
ziprasidone

TO PREPARE
• Review this week’s Learning Resources. Consider the insights they provide about assessing, diagnosing, and treating mood disorders.
• Review the Focused SOAP Note template, which you will use to complete this Assignment. There is also a Focused SOAP Note Exemplar provided as a guide for Assignment expectations.
• Review the video, Case Study: Petunia Park. You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient. The patient will be represented onscreen as an avatar.
• Consider what history would be necessary to collect from this patient.
• Consider what interview questions you would need to ask this patient.
• Consider patient diagnostics missing from the video:
Provider Review outside of interview:
Temp 98.2 Pulse 90 Respiration 18 B/P 138/88
Laboratory Data Available: Urine drug and alcohol screen negative. CBC within normal ranges, CMP within normal ranges. Lipid panel within normal ranges. Prolactin Level 8; TSH 6.3 (H)
THE ASSIGNMENT
Develop a Focused SOAP Note, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:
• Subjective: What details did the patient provide regarding their chief complaint and symptomatology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
• Objective: What observations did you make during the psychiatric assessment? 
• Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
• Plan: What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy.
• Reflection notes: Reflect on this case. Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), social determinates of health, health promotion, and disease prevention that takes into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).