While questioning a depressed patient, it is critical to examine questions such as how frequently they have heard suicidal thoughts, how their sleep has been disturbed in recent weeks, and how many times they have felt hopeless and in despair (American Psychiatric Association, 2013). It would also be necessary to discuss whether their eating patterns have been influenced in any way by their energy intake and food amounts.
When the patient is examined, they may exhibit signs and symptoms such as abdominal pain, weight loss, headache, and exhaustion. They are typically irritated, with a low mood and an inability to concentrate (American Psychiatric Association, 2013). The patient will be screened through various diagnostic tests to ascertain the presence of depression. These tests include Zung self-rating depression test, the Beck depression inventory, PHQ-9 and Hamilton depression eating scale among others (Stockings et al., 2015).
The primary diagnosis for the patient in the presented case is depressive disorder due to the presentation of fatigue and feeling weak with a decline in her school performance and lack of participation in usual activities (American Psychiatric Association, 2013). The differential diagnosis will include anemia due to the loss of energy, Cushing's syndrome presented by the Acanthosis nigricans at the nape of the neck and the sudden change in weight and hypothyroidism as she mostly becomes irritable and angry.
In the initial steps, the patient's family needs to be educated on the presentation of symptoms, treatment options, and their side effects. She will be referred to the psychiatrist to gain both pharmacotherapy and psychotherapy management as a care process for depression (American Psychiatric Association, 2013). She will then be initiated on a selective serotonin uptake inhibitor, Fluoxetine alongside a cognitive behavioral therapy.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Stockings, E., Degenhardt, L., Lee, Y. Y., Mihalopoulos, C., Liu, A., Hobbs, M., & Patton, G. (2015). Symptom screening scales for detecting major depressive disorder in children and adolescents: a systematic review and meta-analysis of reliability, validity and diagnostic utility. Journal of affective disorders, 174, 447-463.
