Question

Select and research one anxiety disorders in chapter 9 of Sadock and Kaplan (S & K) Explain the diagnostic criteria and differential diagnosis. Discuss the treatment regimen including psychotherapy and psychopharmacology. What type of referral would you make for the client with this disorder? Support your rationale

Answer 1

Mood disorders are characterized by a disturbance of mood, accompanied by a full or partial manic or depressive syndrome.

Classification of mood disorders

• Manic episode
• Depressive episode
• Bipolar mood disorders
• Recurrent depressive disorder
• Persistent mood disorder
• Other mood disorders.

Diagnostic criteria

Criterion A

• 5or more the symptoms have been present during the same two weeks period and represent a change for previous functioning. At least one of the six is either

1) depressed mood.

2) loss of interest or pleasure.

1.Depressed mood most of the day, nearly everyday, as indicated by either subjective report or observation made by otherwise

2Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly everyday.

3 Significant weight loss when not dieting or weight gain or decreased or increased in appetite nearly everyday.

4Insomnia or hypersomnia nearly every day.

5Psychomotor agitation or retardation nearly everyday

6Fatigue or loss of energy nearly every day.

7.Feelings of worthlessness or excessive or inappropriate guilt nearly every day.

8Diminished ability to think or concentrate or indecisiveness, nearly every day.

9.Recurrent thoughts or death, recurrent suicidal ideation without specific plan, or a suicide attempt or a specific plan for commiting suicide.

Criterion B

• It can cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

CriterionC

• Episode is not attributable to the physiological effects of substance or to another medical condition.

Differential diagnosis

• Normal sadness, particularly in the context of bereavement or severe physical illness.
• May also precipitate depression.
• Predominant negative, guilty or suicidal thoughts favour and diagnosis of depression.

Psychopharmacology

• Antidepressant medication are the drug of choice to treat patients with depression.
• They are particularly indicated in severe and recurrent depression.
• Despite the treatment success achieved with this drugs, antidepressants have limitations. Their therapeutic effects begin only after 2 to 6 weeks.
• Another major problem with some antidepressants medications is their toxicity.

Psychotherapy

• Cognitive therapy-it aims at correcting the depressive negative cognition like hopelessness, worthlessness and pessimistic ideas and replacing them with new cognitive and behavioral responses.
• Supportive psychotherapy.-Various techniques are employed to support the patient. They are reassurance ,ventilation, occupational therapy, relaxation and other activity therapies.
• Group therapy-it is useful for mild cases of depression. In group therapy negative feelings such as anxiety, anger, guilt despair sre recognized and emotional growth is is improved through expression of their feelings.
• Family therapy-it is used to decrease intrafamilial and interpersonal difficulties and to reduce or modify stress or which may help in faster and more complete recovery.
• Behavior therapy-it includes social skills training, problem solving techniques, assertiveness training, self-control therapy, activity scheduling and decision making techniques.