Major Depressive Disorders: A Case Study

• Scoring: The inventory uses a 5-point scale of distress (0–4), ranging from “not at all” (0) to “extremely” (4). The DIE yields raw scores and T scores for the Total Score and Primary Dimension scores. Results are hand scored. T scores above 65 on the Total Score and the Primary Dimensions are considered in the “clinical range.”

Depression is pervasive in both mental health and medical settings. In the US, the number of discharges with major depressive disorder as first-listed diagnosis was estimated 395,000 for 2010. The CDC also cites the percentage of persons 12 years of age and older with depression in any 2-week period at an estimated 8% between 2007-2010 (CDC, 2015). The American Psychiatric Associates guidelines on treatment of Major Depressive Disorder recommend the ongoing monitoring of symptoms among patients. Specifically, the APA recommends “systemically assessing symptoms of illness and the effects of treatment”. Consideration is given to matching clinical observations with clinician and/or patient administered rating scale measurements for initial and ongoing evaluation (American Psychiatric Association,

DAS is recommended for this group as it is reliable and gives correct prediction and outcomes regarding depression. This assessment tool is easy to use; it is a self-report scale consisting of 40 items with each item having a statement and 7-point Likert scale. The questions used in this assessment are direct and easy making it efficient for most individuals' use (de Graaf, Roelofs, & Huibers, 2009). Besides,

The scores are based on a self-reporting scale (e.g. questionnaire) and are consistent with the DSM-IV criteria for major depression. For this test each item uses a 4-point scale of severity ranging from 0 to 3 (Beck, et al., 1996). Once all questions are answered the publishers have created a cut score guideline to use. The qualifiers are minimal (0-13), mild (14-19), moderate (20-28), and severe (29-63). Again, the terminology was taken from the DSM -IV criteria for major depression and each symptom is looked at based on

According to Smarr (2003), the instrument was validated using college students, adult and adolescent psychiatric outpatients (Smarr, 2003). Today, the BDI-II is widely used for those patients as well as normal populations. According to Wang & Gorenstein (2013), the BDI-II can be easily adapted in most clinical settings for detecting major depression and recommending a suitable intervention (Wang & Gorenstein, 2013). Thus, in health care settings the BDI-II has been BDI-II has been expanding in practice in the pathologically ill to assess depressive states that occur at high prevalence (Wang & Gorenstein, 2013).

Further tests and evaluations are needed for Axes II, III, IV, and V. However, the Axis I diagnosis is based on the primary symptoms reported on intake. These symptoms meet the criteria of the DSM-IV, which stipulates that five of the symptoms be present for a minimum of two weeks for diagnosis of major depressive episode. Both of the two indicating symptoms: chronic depressed mood and loss of interest or pleasure in life are indicated in this patient. The other symptoms that lead to the diagnosis of major depressive episode include significant weight loss, chronic insomnia, fatigue or loss of energy, inability to concentrate, and suicidal ideation.

The patient is a 42 year old male who presented to the ED with suicidal thoughts of walking in front of traffic. The patient reports non compliance with medications. Patient denies homicidal ideations and symptoms of psychosis. The patient describes depressive symptoms as: sadness.

Patients may display signs of an unstable self-image, sense of self or identity disturbance. A patient may be indecisive about his or her life and feel they constantly want to change jobs, may question their sexual identity, and values etc. These feelings lead to the next characteristic, extreme impulsivity in at least two areas that could be harmful such as unsafe sex, substance abuse or reckless driving. (DSM, 2000) The patient may feel unstable and experience rapid mood changes such as irritability or anxiety. They may have chronic feelings of emptiness or boredom which may stimulate self-mutilation. (NIMH)

Empirical or predictive validity is the extent to which scores on one assessment correspond to the same behaviors measured with other assessment instruments. For an assessment to be empirically valid, statistical evidence must suggest the instrument measures what it is meant to measure (Trochim, 2006). The BDI-FastScreen was correlated with two other assessment instruments that measure symptoms of depression and with the diagnostic criteria for depression in the Diagnostic and Statistical Manual of Mental Disorders IV-TR (DSM-IV-TR). The correlations were r = .62 with the Hospital Anxiety and Depression Scale and r = .86, when correlated with the Beck Anxiety Inventory for Primary Care. Correlation with the DSM-IV-TR was

The following essay is a case study of a client named John who is suffering from major depression and was sent to see me for treatment by his concerned wife. I will provide brief background information about John then further discuss interventions and strategies I believe can be applied in each session with my client in order to make John's life more manageable. In the essay, I will be writing as the therapist, and the sessions are based on a ten week period.

Discuss the strengths and weaknesses of DSM-IV TR, as well as new changes for DSM-V.

The volunteer circle 0 for these two sections, which were I can sleep well as usual and my appetite is no worse than usual. The purpose of having these two different sections in the assessment is to take in consideration the criteria for depression described in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The BDI-II had two previous revisions that did not included the same questions that are now included in section 16 and 18 and the change was made in order for the instrument to take in consideration the DSM-IV criteria for depression (Conoley, 1987). For the purpose of this assignment I review the assessment after the volunteer completed by scoring all 21 questions in order to interpret her results for the solely purpose of this assignment. In a real counseling scenario when the client completes the questionnaire for this assessment, the counselor professional ethical duties are to interpret the BDI-II and process the findings during counseling

The alcohol/drug use scale has 8 questions identify significant drug/alcohol use in youth; and the angry-irritable scale has 9 items that identify feelings of anger, frustration, irritability, etc., and a high score indicates at risk for impulsive behavior (Roe-Sepowitz and Krysik, 2008). The depressed-anxious scale has 9 items and focus on depression and anxiety symptoms; and somatic complaints scale contains 6 items about bodily aches and pains and physical manifestations of anxiety which might indicate a disorder or physical illness injury (Roe-Sepowitz and Krysik, 2008). The suicide ideation scale consists of 5 questions which address suicidal thoughts, self-mutilation, and depressive symptoms; and the final scale, traumatic

The BDI items are rated on a 4-point scale (0 the least severe choice to 3 the most severe alternative) and total scores are obtained by tallying the ratings for all 21 items. Scores range from 0 to 63, with higher scores representing increased severity of depression. If an examinee has chosen more than one statement within a particular item group, the administrator is instructed to use the statement with the highest rating to calculate

Jessica is a twenty-eight-year-old married female who works at a large hospital. She has high expectations for herself because she has graduated with honors at both college and medical school. For the past few weeks, she has been feeling tired and unhappy. She has had a demanding and high stressful job at a large hospital for two years. She feels that she is unable to perform well at her job and has trouble concentrating at work and at home. She is uninterested in her usual activities and has many negative thoughts that keep her awake at night. Two diagnoses that best fit this case study are Major Depressive Disorder and Generalized Anxiety Disorder.