Diagnosis and treatment: A patient came to the psychiatrist office and complaine
ID: 71915 • Letter: D
Question
Diagnosis and treatment:
A patient came to the psychiatrist office and complained about feeling being hopeless
and helpless
.
He feels nothing he can do to make any difference in his life. He is losing sleep and cannot get out of
bed. He is not having sex in his marriage nor is he interested in sex any more.
He is worried that he
will get a divorce. He lost his job. He feels he is useless and unable to be a provider for his family.
He is not motivated to find another job. He just sits at home and do nothing, and worry about this is
the end of the world for
him. He is thinking about suicide, but does not have the energy or motivation
to even kill himself. He feels like a failure. He feels there is no hope for him. He is asking to help to
turn his life around.
a.
If you were
a
psychiatrist,
what are
the symp
toms that identify a mental disorder that he has. W
hat
disorder is he likely to have?
b.
What other similar disorders that you can exclude he doesn’t have
?
Why do you think he does not
have the other disorders based on the symptoms
?
c.
What
pharmacotherapy do you prescribe to this patient
?
Why do you think this drug treatment works
according to the theory/model of this disorder?
d.
What neurotransmitter
do the above drugs
act on? What are the side effects
Explanation / Answer
a) The patient is having symptoms of depression
b) The patient symptom shows he has depression and is definitely the symptoms of depression. He doesn’t have schizophrenia or other illness like bipolar disorder.
c) Acute therapy is prescribed with continuation therapy for up to six months to prevent any relapse. Antidepressants are prescribed during the period of acute therapy. Cognitive behavioural therapy is also prescribed. Yes this treatment works very well in patients with depression. Also the long term treatment ensures that the depression don’t occur again.
d) Antidepressants mainly affect the level of norepinephrine and serotonin in the brain. Some antidepressants work by acting on monoamine neurotransmitters. The common side effects include dizziness, dry mouth, weight gain, sexual dysfunction etc