SOCW 6090 week 6

 
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Week 6: Diagnosing Depressive and Bipolar Disorders
Diagnosing a depression is one of the most common—and yet most complex—differential diagnoses a social worker may make. The word itself covers a wide range of variations of the illness from normal sadness to serious clinical depressions that might not present the same way. Clinical depression disorders can look agitated or leaden even within the same specific form of the illness. They can be persistent depressions, mild and adjustment related, or caused by particular life events as in postpartum depressions.
Social workers need to know how to differentiate among types of depressions. They also need to know how to find the overlaps that depression has with other illnesses such as anxiety and trauma disorders.
This week you observe a case of unipolar depression and then apply your diagnostic decision-making process to a case study. You also consider how to differentiate among disorders on these two spectrums and the importance of validating a diagnosis over time.
Learning Objectives
Students will:

Analyze a case study focused on a depressive disorder or bipolar disorder utilizing steps of differential diagnosis
Analyze lived experiences of depression
Evaluate cases to determine accurate mood disorder diagnosis

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Learning Resources
Required Readings
Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.
Chapter 11, “Diagnosing Depression and Mania” (pp. 129–166)
American Psychiatric Association. (2013e). Depressive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm04
American Psychiatric Association. (2013c). Bipolar and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm03
Jain, R., Maletic, V., & McIntyre, R. S. (2017). Diagnosing and treating patients with mixed features. Journal of Clinical Psychiatry, 78(8), 1091–1102. doi:10.4088/JCP.su17009ah1c
Diagnosing and Treating Patients with Mixed Features by Jain, R.; Maletic, V.; McIntyre, R., in Journal of Clinical Psychiatry, Vol. 78/Issue 8. Copyright 2017 by Physicians Postgraduate Press. Reprinted by permission of Physicians Postgraduate Press via the Copyright Clearance Center.
Walton, Q. L., & Payne, J. S. (2016). Missing the mark: Cultural expressions of depressive symptoms among African-American women and men. Social Work in Mental Health, 14(6), 637–657. doi:10.1080/15332985.2015.1133470
Required Media
TED Conferences, LLC (Producer). (2013). Depression, the secret we share [Video file]. Retrieved from https://www.ted.com/talks/andrew_solomon_depression_the_secret_we_share
TEDx Talks. (2013a, May 23). Depression is a disease of civilization: Stephen Ilardi at TedxEmory [Video file]. Retrieved from https://youtu.be/drv3BP0Fdi8
Optional Resources
American Psychiatric Association. (2013b). Assessment measures. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.AssessmentMeasures
Santiago-Rivera, A. L., Benson-Flórez, G., Santos, M. M., & Lopez, M. (2015). Latinos and depression: Measurement issues and assessment. In K. F. Geisinger (Ed.), Psychological testing of Hispanics: Clinical, cultural, and intellectual issues (2nd ed., pp. 255–271). Washington, DC: American Psychological Association. doi:10.1037/14668-014
Thase, M. E., Weisler, R. H., Trivedi, M. H., & Manning, J. S. (2017). Utilizing the DSM-5 Anxious Distress specifier to develop treatment strategies for patients with major depressive disorder. Journal of Clinical Psychiatry, 78(9), 1351–1362. doi:10.4088/JCP.ot17015ah1
Utilizing the DSM-5 Anxious Distress Specifier to Develop Treatment Strategies for Patients with Major Depressive Disorder by Thase, M.; Weisler, R.; Trivedi, M.; Manning, J., in Journal of Clinical Psychiatry, Vol. 78/Issue 9. Copyright 2017 by Physicians Postgraduate Press. Reprinted by permission of Physicians Postgraduate Press via the Copyright Clearance Center.
Document: Suggested Further Reading for SOCW 6090 (PDF)

Note: This is the same document introduced in Week 1.
Discussion: Applying Differential Diagnosis to Depressive and Bipolar Disorders
What is it truly like to have a mental illness? By considering clients’ lived experiences, a social worker becomes more empathetic and therefore better equipped to treat them. In this Discussion, you analyze a case study focused on a depressive disorder or bipolar disorder using the steps of differential diagnosis.
To prepare: View the TED Talk “Depression, the Secret We Share” (TED Conferences, LLC, 2013) and compare the description of Andrew Solomon’s symptoms to the criteria for depressive disorders in the DSM-5. Next review the steps in diagnosis detailed in the Morrison (2014) reading, and then read the case provided by your instructor for this week’s Discussion, considering the client against the various DSM-5 criteria for depressive disorders and bipolar disorders.
By Day 3
Post a 300- to 500-word response in which you address the following:

Provide the full DSM-5 diagnosis for the client. For any diagnosis that you choose, be sure to concisely explain how the client fits that diagnostic criteria. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, medical needs, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
Recommend a specific evidence-based measurement instrument to validate the diagnosis and assess outcomes of treatment.
Describe your treatment recommendations, including the type of treatment modality and whether or not you would refer the client to a medical provider for psychotropic medications.

By Day 6
Respond to at least two colleagues who presented a different diagnosis in the following ways:

Explain the differences and similarities in your choice of criteria used to determine diagnosis, including Z codes (other conditions that may be a focus of clinical attention).
Explain whether or not you agree with your colleague’s treatment recommendations.

Response 1
 Francisco Adame WK 6 DiscussionCOLLAPSE
(F31.81) Bipolar ll Disorder, Hypomanic, With anxious distress, With rapid cycling, Moderate
(Z63.0) Relationship Distress With Spouse or Intimate Partner 
Sofia is a 33-year-old Hispanic female with a wife and three children has looked for treatment due to fear of losing her family due to her behavior. Sofia meets diagnostic criteria for Bipolar ll Disorder as she is presented with a period of abnormally and persistently elevated, expansive and irritable mood with increased activity or energy lasting at least four consecutive dates. She has symptoms of inflated self-esteem or grandiosity, decrease the need for sleep, more talkative, excessive involvement in activities with consequences and is observable by others and previously had suicide attempts, has developed in her mid-20s, and began with a depressive episode until the hypomanic episode began. This is reflected in her prior hospitalization after feeling down, fearful, suicidal, not able to get out of work followed by a period of being on top of the world, buying lots of gifts, being talkative, sleeps very few hours and does not seem to affect her, her mood is up and excited but feels tense. It was specified Hypomanic due to her current episode, With anxious distress due to her tension and rapid cycling based on how frequent it occurs. Moderate was given due to the many symptoms she is displaying of hypomania. For the diagnosis of relational distress it is the major focus as the quality of the relationship is affecting the course of prognosis or treatment as the distress is associated with the impaired functioning in the behavioral domain. Sofia is there because she is worried to lose her family due to her behavior. 
To validate the diagnosis and assess outcomes the 33 item Hypomania Checklist (HCL-33) is a self-reported questionnaire that detects hypomanic symptoms in the past and current episodes and differentiates Bipolar Disorder from Major Depressive Disorder. It includes questions of the hypomanic state and high sensitivity to those symptoms to improve the recognition of the disorder. It was found to be an effective screening tool for the detection of Bipolar Disorder in a clinical setting before and after treatment (Wang, Feng, Xu, Huang, Chow, Ng, Ungvari, Yuan, Wang, & Xiang, 2018). 
Treatment recommendation would begin with a referral with a psychiatrist for evaluation and if needed administration of medication for Bipolar Disorder. I would begin Psychotherapy with Sofia to focus on depressive symptoms and on the issues she has in her relationship with her wife and family due to her disorder. This can be done with the use of Cognitive Behavioral Therapy. Swartz, & Swanson, (2014) states psychotherapy with medication shows to be more effective than medication alone treatment for depressive symptoms and to prevent new mood episodes as well as improving functioning and quality of life. It mentions the use of CBT can be beneficial in the treatment of the disorder although it will have a bigger impact on depression, it can help Sofia with her family issues as well. 
Reference:
Swartz, H. A., & Swanson, J. (2014). Psychotherapy for Bipolar Disorder in Adults: A Review of the Evidence. Focus (American Psychiatric Publishing), 12(3), 251–266. https://doi.org/10.1176/appi.focus.12.3.251
Wang, Y.-Y., Feng, Y., Xu, D.-D., Huang, W., Chow, I. H. I., Ng, C. H., Ungvari, G. S., Yuan, Z., Wang, G., & Xiang, Y.-T. (2018). The development and validation of a short version of the 33-item Hypomania Checklist (HCL-33). Journal of Affective Disorders, 235, 206–210. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jad.2018.04.019

Response 2
 Nicole Martin RE: Discussion Week 6COLLAPSE
Sorry I hit enter and it submitted it!
I am diagnosing Sofia with:
F31.12 Bipolar Disorder 1 Current or most recent episode manic, Moderate
Z63.0 Relationship Distress with Spouse or Intimate Partner

Inflated self-esteem or grandiosity
Decreased need for sleep
More Talkative than usual or pressure to keep talking
Racing thoughts
Excessive involvement in activities that have a hight potential for painful consequences (buying sprees).

Sofia becomes agitated and punches walls. That is part of Criteria A for a manic episode which is irritable mood that can be elevated. She has feelings that she is on top of the world, which is grandiosity. She goes on shopping sprees she can’t afford which is part of excessive involvement in activities that have high potential for painful consequences. She is talking fast, so fast that her wife suspects she is on drugs which is part of being talkative of under pressure to keep talking criteria. She stays up all night and it doesn’t seem to affect her work, this is part of her decreased need for sleep. Sofia has shifts in moods over a period of days which is part of the diagnostic features. 
I would use the Young Mania Rating Scale to measure Sofia’s mania. It has 11 items and is based on the client’s subjective report of her clinical condition over the last 48 hours (Young, 2018). It is based on irritability, speech, thought content and aggressive behaviors. This should give me a good understanding of where Sofia is at and where to begin her treatment.
My treatment recommendations for Sofia would be to get her into therapy  immediately and also into medication management. I do believe that she needs to be on medication to manage her bipolar symptoms so that she is not cycling from mania to depression or anger. I believe the therapy will help her better understand her disease and know what to expect. I also think it would be a good idea for her to have couples counseling so her partner can understand the disease and be supportive while they find the right combination of medicine for Sofia to be on. 
Young RC, Biggs JT, Ziegler VE, Meyer DA, 2018. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429-435
Note: You are required to create a thread for your initial Discussion post before you will be able to view other colleagues’ postings in this forum. If you have not yet visited the weekly resources and assignments, you should visit that area now to access the complete set of directions and guidelines for this discussion.
Note: You do not need to include an APA reference to the DSM-5 in your response. However, your response should clearly be informed by the DSM-5, demonstrating an understanding of the risks and benefits of treatment to the client. You do need to include an APA reference for the measurement tool and any other resources you use to support your response.ek 6: Diagnosing Depressive and Bipolar Disorders
Diagnosing a depression is one of the most common—and yet most complex—differential diagnoses a social worker may make. The word itself covers a wide range of variations of the illness from normal sadness to serious clinical depressions that might not present the same way. Clinical depression disorders can look agitated or leaden even within the same specific form of the illness. They can be persistent depressions, mild and adjustment related, or caused by particular life events as in postpartum depressions.
Social workers need to know how to differentiate among types of depressions. They also need to know how to find the overlaps that depression has with other illnesses such as anxiety and trauma disorders.
This week you observe a case of unipolar depression and then apply your diagnostic decision-making process to a case study. You also consider how to differentiate among disorders on these two spectrums and the importance of validating a diagnosis over time.
Learning Objectives
Students will:

Analyze a case study focused on a depressive disorder or bipolar disorder utilizing steps of differential diagnosis
Analyze lived experiences of depression
Evaluate cases to determine accurate mood disorder diagnosis

Learning Resources
Required Readings
Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.
Chapter 11, “Diagnosing Depression and Mania” (pp. 129–166)
American Psychiatric Association. (2013e). Depressive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm04
American Psychiatric Association. (2013c). Bipolar and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm03
Jain, R., Maletic, V., & McIntyre, R. S. (2017). Diagnosing and treating patients with mixed features. Journal of Clinical Psychiatry, 78(8), 1091–1102. doi:10.4088/JCP.su17009ah1c
Diagnosing and Treating Patients with Mixed Features by Jain, R.; Maletic, V.; McIntyre, R., in Journal of Clinical Psychiatry, Vol. 78/Issue 8. Copyright 2017 by Physicians Postgraduate Press. Reprinted by permission of Physicians Postgraduate Press via the Copyright Clearance Center.
Walton, Q. L., & Payne, J. S. (2016). Missing the mark: Cultural expressions of depressive symptoms among African-American women and men. Social Work in Mental Health, 14(6), 637–657. doi:10.1080/15332985.2015.1133470
Required Media
TED Conferences, LLC (Producer). (2013). Depression, the secret we share [Video file]. Retrieved from https://www.ted.com/talks/andrew_solomon_depression_the_secret_we_share
TEDx Talks. (2013a, May 23). Depression is a disease of civilization: Stephen Ilardi at TedxEmory [Video file]. Retrieved from https://youtu.be/drv3BP0Fdi8
Optional Resources
American Psychiatric Association. (2013b). Assessment measures. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.AssessmentMeasures
Santiago-Rivera, A. L., Benson-Flórez, G., Santos, M. M., & Lopez, M. (2015). Latinos and depression: Measurement issues and assessment. In K. F. Geisinger (Ed.), Psychological testing of Hispanics: Clinical, cultural, and intellectual issues (2nd ed., pp. 255–271). Washington, DC: American Psychological Association. doi:10.1037/14668-014
Thase, M. E., Weisler, R. H., Trivedi, M. H., & Manning, J. S. (2017). Utilizing the DSM-5 Anxious Distress specifier to develop treatment strategies for patients with major depressive disorder. Journal of Clinical Psychiatry, 78(9), 1351–1362. doi:10.4088/JCP.ot17015ah1
Utilizing the DSM-5 Anxious Distress Specifier to Develop Treatment Strategies for Patients with Major Depressive Disorder by Thase, M.; Weisler, R.; Trivedi, M.; Manning, J., in Journal of Clinical Psychiatry, Vol. 78/Issue 9. Copyright 2017 by Physicians Postgraduate Press. Reprinted by permission of Physicians Postgraduate Press via the Copyright Clearance Center.
Document: Suggested Further Reading for SOCW 6090 (PDF)

Note: This is the same document introduced in Week 1.
Discussion: Applying Differential Diagnosis to Depressive and Bipolar Disorders
What is it truly like to have a mental illness? By considering clients’ lived experiences, a social worker becomes more empathetic and therefore better equipped to treat them. In this Discussion, you analyze a case study focused on a depressive disorder or bipolar disorder using the steps of differential diagnosis.
To prepare: View the TED Talk “Depression, the Secret We Share” (TED Conferences, LLC, 2013) and compare the description of Andrew Solomon’s symptoms to the criteria for depressive disorders in the DSM-5. Next review the steps in diagnosis detailed in the Morrison (2014) reading, and then read the case provided by your instructor for this week’s Discussion, considering the client against the various DSM-5 criteria for depressive disorders and bipolar disorders.
By Day 3
Post a 300- to 500-word response in which you address the following:

Provide the full DSM-5 diagnosis for the client. For any diagnosis that you choose, be sure to concisely explain how the client fits that diagnostic criteria. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, medical needs, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
Recommend a specific evidence-based measurement instrument to validate the diagnosis and assess outcomes of treatment.
Describe your treatment recommendations, including the type of treatment modality and whether or not you would refer the client to a medical provider for psychotropic medications.

By Day 6
Respond to at least two colleagues who presented a different diagnosis in the following ways:

Explain the differences and similarities in your choice of criteria used to determine diagnosis, including Z codes (other conditions that may be a focus of clinical attention).
Explain whether or not you agree with your colleague’s treatment recommendations. 

Week 6: Diagnosing Depressive and Bipolar Disorders
Diagnosing a depression is one of the most common—and yet most complex—differential diagnoses a social worker may make. The word itself covers a wide range of variations of the illness from normal sadness to serious clinical depressions that might not present the same way. Clinical depression disorders can look agitated or leaden even within the same specific form of the illness. They can be persistent depressions, mild and adjustment related, or caused by particular life events as in postpartum depressions.
Social workers need to know how to differentiate among types of depressions. They also need to know how to find the overlaps that depression has with other illnesses such as anxiety and trauma disorders.
This week you observe a case of unipolar depression and then apply your diagnostic decision-making process to a case study. You also consider how to differentiate among disorders on these two spectrums and the importance of validating a diagnosis over time.
Learning Objectives
Students will:

Analyze a case study focused on a depressive disorder or bipolar disorder utilizing steps of differential diagnosis
Analyze lived experiences of depression
Evaluate cases to determine accurate mood disorder diagnosis

Learning Resources
Required Readings
Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.
Chapter 11, “Diagnosing Depression and Mania” (pp. 129–166)
American Psychiatric Association. (2013e). Depressive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm04
American Psychiatric Association. (2013c). Bipolar and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm03
Jain, R., Maletic, V., & McIntyre, R. S. (2017). Diagnosing and treating patients with mixed features. Journal of Clinical Psychiatry, 78(8), 1091–1102. doi:10.4088/JCP.su17009ah1c
Diagnosing and Treating Patients with Mixed Features by Jain, R.; Maletic, V.; McIntyre, R., in Journal of Clinical Psychiatry, Vol. 78/Issue 8. Copyright 2017 by Physicians Postgraduate Press. Reprinted by permission of Physicians Postgraduate Press via the Copyright Clearance Center.
Walton, Q. L., & Payne, J. S. (2016). Missing the mark: Cultural expressions of depressive symptoms among African-American women and men. Social Work in Mental Health, 14(6), 637–657. doi:10.1080/15332985.2015.1133470
Required Media
TED Conferences, LLC (Producer). (2013). Depression, the secret we share [Video file]. Retrieved from https://www.ted.com/talks/andrew_solomon_depression_the_secret_we_share
TEDx Talks. (2013a, May 23). Depression is a disease of civilization: Stephen Ilardi at TedxEmory [Video file]. Retrieved from https://youtu.be/drv3BP0Fdi8
Optional Resources
American Psychiatric Association. (2013b). Assessment measures. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.AssessmentMeasures
Santiago-Rivera, A. L., Benson-Flórez, G., Santos, M. M., & Lopez, M. (2015). Latinos and depression: Measurement issues and assessment. In K. F. Geisinger (Ed.), Psychological testing of Hispanics: Clinical, cultural, and intellectual issues (2nd ed., pp. 255–271). Washington, DC: American Psychological Association. doi:10.1037/14668-014
Thase, M. E., Weisler, R. H., Trivedi, M. H., & Manning, J. S. (2017). Utilizing the DSM-5 Anxious Distress specifier to develop treatment strategies for patients with major depressive disorder. Journal of Clinical Psychiatry, 78(9), 1351–1362. doi:10.4088/JCP.ot17015ah1
Utilizing the DSM-5 Anxious Distress Specifier to Develop Treatment Strategies for Patients with Major Depressive Disorder by Thase, M.; Weisler, R.; Trivedi, M.; Manning, J., in Journal of Clinical Psychiatry, Vol. 78/Issue 9. Copyright 2017 by Physicians Postgraduate Press. Reprinted by permission of Physicians Postgraduate Press via the Copyright Clearance Center.
Document: Suggested Further Reading for SOCW 6090 (PDF)

Note: This is the same document introduced in Week 1.
Discussion: Applying Differential Diagnosis to Depressive and Bipolar Disorders
What is it truly like to have a mental illness? By considering clients’ lived experiences, a social worker becomes more empathetic and therefore better equipped to treat them. In this Discussion, you analyze a case study focused on a depressive disorder or bipolar disorder using the steps of differential diagnosis.
To prepare: View the TED Talk “Depression, the Secret We Share” (TED Conferences, LLC, 2013) and compare the description of Andrew Solomon’s symptoms to the criteria for depressive disorders in the DSM-5. Next review the steps in diagnosis detailed in the Morrison (2014) reading, and then read the case provided by your instructor for this week’s Discussion, considering the client against the various DSM-5 criteria for depressive disorders and bipolar disorders.
By Day 3
Post a 300- to 500-word response in which you address the following:

Provide the full DSM-5 diagnosis for the client. For any diagnosis that you choose, be sure to concisely explain how the client fits that diagnostic criteria. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, medical needs, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
Recommend a specific evidence-based measurement instrument to validate the diagnosis and assess outcomes of treatment.
Describe your treatment recommendations, including the type of treatment modality and whether or not you would refer the client to a medical provider for psychotropic medications.

By Day 6
Respond to at least two colleagues who presented a different diagnosis in the following ways:

Explain the differences and similarities in your choice of criteria used to determine diagnosis, including Z codes (other conditions that may be a focus of clinical attention).
Explain whether or not you agree with your colleague’s treatment recommendations.

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