Assessing, diagnosing, and treating mood disorders.

Patients presenting with mood disorders may find that their moods impact their ability to function or that their moods are not consistent with their circumstances. Bipolar and related disorders are one category of mood disorders. They affect nearly 3% of the U.S. population each year (Depression and Bipolar Support Alliance, n.d.). Although being relatively rare in terms of lifetime prevalence, bipolar disorder is burdensome to the individual and health care system because of its early onset, severity, and chronic nature. The average age of onset is around 25 and it affects men and women equally.

The importance of evidence-based intervention for treatment in persons with mood disorders cannot be underestimated. Unstable moods can result in repeat chronic hospitalizations and profound life disruption. Mood disorders are a leading cause of disability worldwide and can contribute to suicide (World Health Organization, 2020). Practitioners should understand that developing a good rapport and relationship with the patient can make a significant difference in the course, symptom management, and stability of the patient.

This week, you will assess, diagnose, and develop appropriate treatment plans for adults presenting with mood disorders.

Learning Objectives

Students will:

• Assess adults presenting with mood disorders
• Develop differential diagnoses for adult patients with mood disorders
• Develop appropriate treatment plans for adult patients with mood disorders
• Advocate health promotion and patient education strategies for adult patients with mood disorders

 

Learning Resources

Required Readings (click to expand/reduce)

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

• Chapter 8, “Mood Disorders”

Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.

• Chapter 11, “Mood Disorders”

Document: Focused SOAP Note Template

Document: Focused SOAP Note Exemplar

Required Media (click to expand/reduce)

CrashCourse. (2014, September 8). Depressive and bipolar disorders: Crash course psychology #30 [Video]. YouTube. https://youtu.be/ZwMlHkWKDwM https://www.youtube.com/watch? v=ZwMlHkWKDwM&t=1s

Walden University. (2021). Case study: Petunia Park. Walden University Blackboard. https://class.waldenu.edu

Accessible player Medication Review

Review the FDA approved use of the following medicines related to treating mood disorders.

 

Seasonal Premenstrual                             affective Depression                                                                                        dysphoric disorder                   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                                   Bipolar                                 Mania Mania/Depression                                             maintenance
lithium (used with lurasidone) lurasidone	aripiprazole asenapine carbamazepin		olanzapine ziprasidone		aripiprazole lamotrigine		aripipraz ole asenapin

 

Seasonal Premenstrual                             affective Depression                                                                                        dysphoric disorder                   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
olanzapine- fluoxetine combination (symbyax) quetiapine valproate (divalproex) (used with lurasidone)	e				lithium olanzapine		e carbamaz epine lithium olanzapin e quetiapin e

 

Seasonal Premenstrual                             affective Depression                                                                                        dysphoric disorder                   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
							risperido ne   valproate (divalpro ex) ziprasido ne

 

Seasonal Premenstrual                             affective Depression                                                                                        dysphoric disorder                   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

 

Assignment: Assessing, Diagnosing, and Treating Adults With Mood Disorders

Photo Credit: Monkey Business / Adobe Stock

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.

To Prepare

• Review this week’s Learning 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 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 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
• Consider what interview questions you would need to ask this 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 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 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: What would you do differently with this client if you could conduct the session again? Discuss what your next intervention would be if you were able to follow up with this patient. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion, and disease prevention that takes into consideration patient factors (such as age, ethnic group, ), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

By Day 7 of Week 4

Submit your Focused SOAP Note. Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK4Assgn+last name+first (extension)” as the name.
• Click the Week 4 Assignment Rubric to review the Grading Criteria for the
• Click the Week 4 Assignment You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your Grading Criteria

To access your rubric:

Week 4 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draf t for authenticity:

Submit your Week 4 Assignment draf t and review the originality report.

Submit Your Assignment by Day 7 of Week 4

To participate in this Assignment:

Week 4 Assignment

What’s Coming Up in Week 5?

Next week, you will explore mood and anxiety disorders in children and adolescents and the unique approaches to assessment and treatment of these disorders in this population compared to treating them in adults. In next week’s Assignment, you will prepare patient education materials for an assigned disorder in which you will explain signs and symptoms, pharmacological and nonpharmacological treatments, and community resources.

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Midterm Exam

Photo Credit: [Vergeles_Andrey]/[iStock / Getty Images Plus]/Getty Images

You should also begin studying for your midterm exam, which is completed in Week 6. This will be a 100- question, multiple-choice exam covering all topics in Week 1 through Week 6 of the course. The exams in your MSN program are designed to test your knowledge in preparation for your certification exam and to simulate the certification exam environment. Accordingly, no outside resources, including books, notes, websites, or any other type of resource, may be used to help you complete the exams in your courses.

Next Week

To go to the next week:

Week 5

	Novice	Competent
Create documentation in the Focused SOAP Note Template about the patient in the case study.     In the Subjective section, provide:   •  Chief complaint	14 (14%) – 15 (15%) The response throughly and accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis.	12 (12%) – 13 (13%) The response accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis.
•  History of present illness (HPI)
•  Past psychiatric history
•  Medication trials and current medications
•  Psychotherapy or previous psychiatric diagnosis
•  Pertinent substance use, family psychiatric/substance use, social, and medical history
•  Allergies
•  ROS
In the Objective section, provide:	14 (14%) – 15 (15%) The response thoroughly and accurately documents the	12 (12%) – 13 (13%) The response accurately documents the patient’s

 

	Novice	Competent
•  Physical exam documentation of systems pertinent to the chief complaint, HPI, and history	patient’s physical exam for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented.	physical exam for pertinent systems. Diagnostic tests and their results are accurately documented.
•  Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses
In the Assessment section, provide:   •  Results of the mental status examination, presented in paragraph form   •  At least three differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5 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.	18 (18%) – 20 (20%) The response thoroughly and accurately documents the results of the mental status exam.   Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides a thorough, accurate, and detailed justification for each of the disorders selected.	16 (16%) – 17 (17%) The response accurately documents the results of the mental status exam.   Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides an accurate justification for each of the disorders selected.

 

	Novice	Competent
In the Plan section, provide:   •  Your plan for psychotherapy	23 (23%) – 25 (25%) The response provides an evidence-based, detailed, and appropriate plan for psychotherapy for the patient.	20 (20%) – 22 (22%) The response provides an evidence-based and appropriate plan for psychotherapy for the patient.
•  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.   •  Incorporate one health promotion activity and one patient education strategy.	The response provides an evidence-based, detailed, and appropriate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. A strong rationale for the plan is provided that demonstrates critical thinking and content understanding.   The response includes at least one evidence-based health promotion activity and one evidence-based patient education strategy.	The response provides an evidence-based and appropriate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. An adequate rationale for the plan is provided.   The response includes at least one health promotion activity and one patient education strategy.
•  Reflect on this case.	5 (5%) – 5 (5%)	4 (4%) – 4 (4%)
Discuss what you	Reflections are thorough,	Reflections demonstrate critical
learned and what you	thoughtful, and demonstrate	thinking.
might do differently.	critical thinking.
Also include in your
reflection a discussion
related to legal/ethical
considerations
(demonstrate critical
thinking beyond
confidentiality and
consent for treatment!),
health promotion, and
disease prevention that
takes into consideration
patient factors (such as
age, ethnic group, etc.),
PMH, and other risk

 

	Novice	Competent
factors (e.g., socioeconomic, cultural background, etc.).
Provide at least three	9 (9%) – 10 (10%)	8 (8%) – 8 (8%)
evidence-based, peer-	The response provides at least	The response provides at least
reviewed journal articles	three current, evidence-based	three current, evidence-based
or evidenced-based	resources from the literature to	resources from the literature
guidelines that relate to	support the assessment and	that appropriately support the
this case to support	diagnosis of the patient in the	assessment and diagnosis of
your diagnostics and	assigned case study. The	the patient in the assigned
differential diagnoses.	resources reflect the latest	case study.
Be sure they are current	clinical guidelines and provide
(no more than 5 years old).	strong justification for decision making.
Written Expression and Formatting – The paper follows correct APA format for parenthetical/in-text citations and reference list.	5 (5%) – 5 (5%) Uses correct APA format with no errors	4 (4%) – 4 (4%) Contains a few (one or two) APA format errors
Written Expression and Formatting – English Writing Standards:	5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors	4 (4%) – 4 (4%) Contains a few (one or two) grammar, spelling, and punctuation errors
Correct grammar, mechanics, and punctuation
	Total Points: 100

	Name: NRNP_6665_Week4_Assignment_Rubric

Reference:

Depression and Bipolar Support Alliance. (n.d.). Bipolar disorder statistics. https://www.dbsalliance.org/education/bipolar-disorder/bipolar-disorder-statistics/#

World Health Organization. (2020). Depression. https://www.who.int/news-room/fact-sheets/detail/depression

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In this post, you will assess, diagnose, and devise a treatment plan for a patient in a case study who is presenting with a mood disorder.

Review 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).

MAIN 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.).

Reading Resources

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th

ed.). Wolters Kluwer.

Chapter 8, “Mood Disorders”

Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual.

Springer.

Chapter 11, “Mood Disorders”

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=1s

Walden University. (2021). Case study: Petunia Park. Walden University

Blackboard. https://waldenu.instructure.com

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