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 eliminate differentials and to determine diagnosis, focusing on Z codes (other conditions that may be a focus of clinical attention).
Make a recommendation for a measure that would help validate the diagnosis your peer identified, and explain why you would recommend the measure.
Use references from original discussion, Be detailed in response and use sub heading in response, also be able to really justify your response.)
Response to Latasha
F43.23, Adjustment Disorder with mixed anxiety and depressed mood
F32.3, Major Depressive Disorder with psychotic features
Z60.2 Problems related to living alone
In the case of Sam, he is experiencing increased feelings of depression since his daughter moved out of the apartment they shared for many years and in with her boyfriend. Sam reported difficulty living alone and feeling lonely and anxious. He misses his daughter terribly and feels sad about her departure. As far as criteria from the DSM-5 is concerned for adjustment disorder, Sam meets the criteria of the onset of emotional symptoms in response to a stressor, which is his daughter’s moving out. Also, his distress is out of proportion to the severity of the stressor. His symptoms were brought on by this occurrence; therefore, is not directly related to a preexisting disorder. Also, his symptoms are not of normal reaction to his adult child moving out of the home. Sam reports feeling anxious and depressed and that is how I determined which ICD-10 to use for the adjustment disorder.
I opted to stay with the diagnosis of major depressive disorder with psychotic features because this is Sam’s current diagnosis that is actively being treated. Even though it has been over a period of 10 years, he has been stabilized and controlled with medications for this diagnosis. There is no proof just yet that if not on these medications that the major depression would cease; therefore, he would still fall under this diagnosis.
I chose the other condition that may be a focus of clinical attention as problems related to living alone because Sam reports feelings of loneliness and since his daughter has left there has been a problem with a mix up of his medications. Whereas, the social worker has asked the daughter to go back into the home and check Sam’s medications to determine the issue. This brings concern to Sam living alone and whether or not he would be able to take care of his medical needs appropriately. Mixing up his medication has cause some medical issues that resolved once the mix up was corrected.
When diagnosing depression and mania social workers must be very careful to focus heavily on the symptoms and make sure criteria is fitting to the decision made. Depression can present in many forms and can easily be mistaken for other diagnoses (Morrison, 2014).
Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press
Response to Heather
Sam is a 62 year old African American male. He is widowed. Same lives on his own but is unemployed and receives social security benefits. Sam was a single father to his daughter, Melissa. This was after his wife passed away. Sam is very close to Melissa but doesn’t have any other peer relations. Sam became very depressed when Melissa and her dog moved in with her boyfriend and left the apartment that they had been sharing. He was so depressed that the social worker treating him recommended that the dog move back in with him if there was any way that was possible. When sam was 7 he was placed in foster care and didn’t get much contact with his extended family. After 9-11 Sam became depressed and psychotic and ended up in the emergency room with an episode.
Major depressive disorder F33.1
Psychotic disorder due to another medical condition F06.2
bipolar disorder F31.4