Assessing, diagnosing, and treating mood disorders.

When mood disorders are prevalent, patients may discover that their moods interfere with their capacity to work or are inconsistent with their situation. One group of mood disorders includes bipolar disorder and related conditions. Each year, they impact over 3% of the American population (Depression and Bipolar Support Alliance, n.d.). Bipolar disorder is burdensome to the individual and the healthcare system because of its early start, severity, and chronic nature, although being relatively uncommon in terms of lifetime prevalence. It affects both men and women equally and typically manifests around the age of 25.

It is essential to use evidence-based interventions when treating people with mood disorders. Abnormal moods can cause severe life disruption and recurrent chronic hospitalizations. Mood disorders are a major global contributor to disability and can lead to suicide (World Health Organization, 2020). The patient’s course, symptom management, and stability can all be significantly affected by a practitioner’s ability to establish a positive rapport and relationship with the patient.

This week, you will evaluate, identify, and create suitable treatment plans for adults presenting with mood disorders.

Learning Intentions

Learners will:

Examine adults who are displaying mood issues.

For adult patients with mood problems, develop alternative diagnoses.

Create therapy programs that are suited for adult patients with mood disorders.

Encourage adult patients with mood disorders to use patient education and health promotion strategies.

Learning Materials

Needed texts (click to expand/reduce)

Ruiz, P., Sadock, B. J., and Sadock, V. A. (2015). Mental health overview by Kaplan and Sadock (11th ed.). Wordsworth Kluwer.

In Chapter 8, “Mood Disorders,”

Zakahi, R. (2020). the certification review guide for psychiatric-mental health nurses. Springer.

Section 11.1, “Mood Disorders,”

Template for Targeted SOAP Notes

Focused SOAP Note Model Document

 

(Click to expand/reduce Needed Media)

CrashCourse. (September 8, 2014). Bipolar and depressive disorders: [Video] Crash course in psychology #30. YouTube. Visit YouTube at https://www.youtube.com/watch?v=ZwMlHkWKDwM. v=ZwMlHkWKDwM&t=1s

 

Walden College. (2021). Study case: Petunia Park. The University of Walden Blackboard. https://class.waldenu.edu

Player accessibility Medication Review

Examine the following medications’ FDA-approved uses for 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

Adults With Mood Disorders: Screening, Diagnosing, and Treatment

Picture courtesy of Adobe Stock and Monkey Business

In order to evaluate patients who arrive with these diseases and effectively develop a diagnosis and treatment plan, the PMHNP must have a thorough grasp of mood disorders. When a patient’s emotional state satisfies the diagnostic criteria for severity, functional impact, and duration of a problem, a mood disorder diagnosis may be made. When someone has a mood illness, their emotions may get in the way of their ability to operate daily in their jobs, relationships, or other areas of their lives. Although mood disorders are unlikely to go away independently, they can be managed with an efficient treatment plan and knowledge of how to manage symptoms. Mood disorders may also result in substance misuse or suicidal thoughts or acts.

You will evaluate, identify, and develop a treatment plan for a patient in a case study who exhibits symptoms of a mood disorder in this Assignment.

To Get Ready

Evaluate the learning from this week. Please pay attention to the information they offer on identifying, diagnosing, and treating mood disorders.

Examine the Focused SOAP Note template you will be using to accomplish this Assignment. A Focused SOAP Note Exemplar is also provided as a roadmap for the Assignment’s requirements.

Review Case Study: Petunia Park in the video. In this video, a member of the Walden faculty is evaluating a dummy patient. You will utilize this case as the foundation for this. An avatar of the patient will appear on the screen.

Think about the history that may be gathered from this.

Think about the interview questions you would need to ask for this task.

Create a Focused SOAP Note that details your primary diagnosis, differential diagnosis, and critical thinking process. Include the following information in your template responses:

Subjective: What information about the patient’s main complaint and symptomatology did you receive in order to make your differential diagnosis? How long have they had these symptoms, and how severe are they? What effects do their symptoms have on how they operate in daily life?

What findings did you get from the psychological evaluation?

A discussion of the patient’s mental status evaluation was part of the assessment. What other diagnosis did you consider? Provide at least three potential diagnoses, sorted from highest to lowest importance and backed up by supporting data. To arrive at a precise diagnosis, compare the DSM-5 diagnostic criteria for each differential diagnosis and explain which DSM-5 criteria rule the differential diagnosis out. Describe the critical thinking process you used to arrive at the chosen primary diagnosis. For the particular patient instance, include pertinent positives and pertinent negatives.

What is your strategy for going to therapy? What are your treatment and management strategies, taking into account complementary therapies? Provide a justification for this treatment, pharmacologic and nonpharmacologic medicines, complementary therapies, and follow-up guidelines.

Scheme of management. Include one plan for patient education as well as one action for health promotion.

Notes for reflection: If you could rerun this session, what would you change about this client? If you can follow up with this patient, talk about your next course of action. Include a discussion on health promotion and illness prevention that takes into account patient factors (such as age, ethnic group, PMH, and other risk factors) as well as legal and ethical considerations (showcase critical thinking beyond confidentiality and consent for treatment!) (e.g., socioeconomic, cultural background, etc.).

By Week 4, Day 7

Please send in your Focused SOAP Note. Details about Submission and Grading

Do the following to turn in your finished Assignment for review and evaluation:

Please store your Assignment using the name “WK4Assgn+last name+first (extension)” in accordance with the naming standard.

Review the Week 4 Assignment Rubric to see how the Assignment will be graded.

Select the Week 4 Task to view the rubric for this section’s grading standards.

Then, click Open in the Attach File section after selecting Browse My Computer to locate the file you saved with the extension “WK4Assgn+last name+first initial. (extension)”.

If appropriate, select the I agree to submit my paper(s) to the Global Reference Database checkbox from the Plagiarism Tools section.

To finish your grading criteria, click the Submit button.

Get your rubric here:

Rubric for Week 4 assignments

Verify the authenticity of your Assignment’s draft.

To verify the validity of your assignment document:

Send in your Week 4 assignment, then check the report on originality.

Assignments must be turned in by Day 7 of Week 4.

In order to complete this Assignment:

Week 4 Project

What Happens in Week 5?

Next week, you will learn about how to assess and treat mood and anxiety disorders in children and adolescents, as well as how these disorders are treated differently in this demographic than they are in adults. You will create patient education materials for a given disorder in next week’s Assignment, outlining its signs and symptoms, pharmacological and nonpharmacological treatments, and available resources in the local area.

Brian Jackson/iStock/Getty Images Plus/Getty Images provided the image.

Exam, midterm

Vergeles Andrey/iStock/Getty Images Plus/Getty Images contributed this image.

Moreover, it would help if you started preparing for your midterm exam, which is in Week 6. This test will consist of 100 multiple-choice questions and will cover all material from Weeks 1 through Week 6 of the course. The exams you will take as part of your MSN program are made to assess your knowledge in advance of your certification exam and to replicate the certification exam setting. Furthermore, you are not permitted to use any outside resources—including books, notes, websites, or any other kind of source—to assist you in passing the tests for your courses.

coming week

To the following 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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