Case scenario:
Rita is an 18-365 days-worn who presents to the emergency division alongside with her of us after telling them earlier in the day that she did no longer are searching to be alive anymore. Rita reports that for the past 6 months she has been “feeling down,” and he or she has been having thoughts of killing herself all the arrangement by the closing week. She has a opinion to abolish herself that involves taking the entire medications in her household’s medication cabinet.
Rita says that in the past 6 months she furthermore has skilled a decrease in vitality, announcing that “it feels cherish I’m on no tale ready to sleep.” Her of us dispute you that she changed into beforehand on the music team at her school, and that she stopped going to seem at 2 months in the past because she “didn’t uncover the level” any extra.
Despite quitting the music team, the patient reports a weight loss of 5 pounds in the past 6 months due to a decrease in her appetite. She denies fevers, chills, dizziness, lightheadedness, headache, vision modifications, chest trouble, palpitations, shortness of breath, cough, abdominal trouble, nausea, vomiting, dysuria, auditory hallucinations, and visual hallucinations. She has no well-known past clinical, surgical, or psychiatric historic past. Upon extra interview, Rita denies any historic past of substance utilize, any historic past of manic or hypomanic signs, or any identifiable recent life stressors.
Her laboratory outcomes video show no abnormalities in thyroid-stimulating hormone ranges, comprehensive metabolic panel, or full blood count. Her urine drug video note is detrimental. Valuable signs prove her blood stress is 102/70 mm Hg, respiration charge is 15/min, heart charge is 72/min, and temperature is 37.1 °C (98.8 °F).
• What’s the diagnosis for Rita?
• What’s the doubtless differential diagnosis?
• What diversified clinical conditions can design depressive signs?
• What are the diagnostic criteria for significant depressive disorders?
• What are the proof-primarily primarily based therapy alternatives for significant depressive disorders?
• Will you imply inpatient hospitalization for Rita? Point to why or why no longer?
• What are the ethical concerns for involuntary hospitalization?
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