I am replying to my classmate’s post on mental health assessment |

Re: Week 13 Discussion 1: Mental Health Assessment and Screening

by Whitney Poppell – Monday, 27 March 2023, 10:02 AM

The purpose of this discussion is to discuss how a patient with a mental health disorder may present to the clinical setting. For this discussion, I have chosen to explore a patient with the mental health disorder of Major Depressive Disorder (MDD). First, I will discuss symptoms that may appear in their subjective assessment. The patient may describe a lack of interest or pleasure in activities that they used to enjoy (American Psychiatric Association, 2013). The patient may describe having a depressed mood most every day (American Psychiatric Association, 2013). This could be described as feeling sad, feeling empty, or feeling hopeless (Bains & Abdijadid, 2022). The patient may describe a loss of appetite or occasionally an increase in appetite (American Psychiatric Association, 2013). They may state that they are having sleep disturbances, which include both insomnia and hypersomnia (Lyness, 2022). The patient may be experiencing fatigue, low energy, or decreased ability to concentrate (Lyness, 2022). They may describe feelings of worthlessness, excessive guilt, or recurrent thoughts of death or suicidal ideation (Lyness, 2022). They may describe experiencing dysfunction in different areas of their lives, including social and occupational (Christensen et al., 2020).Second, I will discuss signs and symptoms that may appear during the objective assessment of a patient with Major Depressive Disorder. A Mental Status Exam should be completed during the assessment of a patient who presents with MDD (Bains & Abdijadid, 2022). This exam is a great way to gather objective data on the patient. The patient may be positive for restlessness or psychomotor agitation (American Psychiatric Association, 2013). They may show signs of weight loss or weight gain when compared to previously documented weight (Lyness, 2022). The patient may show signs of anhedonia, which is the decreased ability to feel pleasure, during the health assessment (Christensen et al., 2020). The patient may show signs of decreased concentration and inability to focus during the verbal health assessment (Lyness, 2022). During this exam, the patient may present with a disheveled appearance and lack of good hygiene (Christensen et al., 2020). Their mood will likely appear depressed, and they may be withdrawn during the interview (Lyness, 2022). The patient may be tearful during the assessment (Bains & Abdijadid, 2022).The assessment of a patient with Major Depressive Disorder may be affected by the symptoms of depression. If the patient has a depressed mood and is withdrawn, they may be less likely to openly communicate during the assessment. It is also important to mention that a patient with depression may not even come into an appointment due to their depressive symptoms. Depression symptoms affect a patient’s psychosocial functioning and can prevent a patient from making and/or attending a doctor’s appointment (Christensen et al., 2020). It is possible that a patient with depression may have a lack of trust in the healthcare provider, which may negatively impact the relationship. Patients with mental health disorders often experience stigma from the healthcare system, which leads to lower quality care (Coombs et al., 2021). If a patient has previously experienced this, they may be less likely to actively participate in the assessment.ReferencesAmerican Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. (5th ed.). American Psychiatric Publishing, Inc.Bains, N., & Abdajadid, S. (2022). Major depressive disorder. National Library of Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK559078/Christensen, M., Wong, C., & Baune, B. (2020). Symptoms of major depressive disorder and their impact on psychosocial functioning in the different phases of the disease: Do the perspectives of patients and healthcare providers differ? Frontiers in Psychiatry, 11. https://doi.org/10.3389.fpsyt.2020.00280Coombs, N. C., Meriwether, W. E., Caringi, J., & Newcomer, S. R. (2021). Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study. SSM – Population Health, 15, 100847. https://doi.org/10.1016/j.ssmph.2021.100847Lyness, J. (2022). Unipolar depression in adults: Assessment and diagnosis. UpToDate. Retrieved from https://www-uptodate-com.regiscollege.idm.oclc.org/contents/unipolar-depression-in-adults-assessment-and-diagnosis?search=major%20depressive%20disorder&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H105621478

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