Applying Differential Diagnosis to Depressive and Bipolar

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 determine diagnosis, including Z codes (other conditions that may be a focus of clinical attention). Explain whether or not you agree with your colleague’s treatment recommendations. Colleague 1:Samele Mayfield Initial Post-Mayfield COLLAPSE Ronald is a 39-year-old white male who was admitted to the psychiatric facility on in March, 2021. Ronald reports anxiety and depression since the fall. He was hospitalized in August 2020, due to colitis. Based on observations and client self-report, Ronald’s diagnosis is as follows: F06.32 Depressive Disorder Due to Irritable Bowel Syndrome, with major depressive -like episode F42.2 Obsessive-Compulsive Disorder, with good insight Z63.7 Other stressful life events affecting family and household Diagnostic Criteria Depressive Disorder Due to Irritable Bowel Syndrome, with major depressive -like episode All of the criteria were met for Depressive Disorder Due to Irritable Bowel Syndrome, with major depressive -like episode: (A-E). There has been shown to be a relationship between colitis/IBS and depression (Hood et al., 2018). Additionally, Ronald began taking Lotronex, a drug approved only for women who have Irritable Bowel Syndrome in August of 2020. He reports that his depression began at during this time, and that he has been moody and depressed since fall. Lotronex is not approved for men as it has not been deemed beneficial and Lotronex has been known to cause a rare but possible side effect of depression and psychosis (Alosetron Side Effects: Common, Severe, Long Term – drugs.com, n.d.). For this reason depression due to substance was considered and Lotronex usage should be discontinued. Obsessive-Compulsive Disorder, with good insight Ronald’s symptoms meet the criteria for obsessive-compulsive disorder, with good insight as he has (A) Obsessions-recurrent and persistent thoughts about money and losing his job. He also has compulsions, banging the refrigerator 4 times, looking for dust and vacuuming if he has any and making sure there are even number of cans in the cabinet. The compulsions are time consuming (B). and are not attributable to substance or another mental disorder (C,D). Other stressful life events affecting family and household Ronald has experienced other stressful life events such as his mother in law’s death, family illness and job functions changing. Diagnostic tools The tool I would use to validate the diagnosis and assess outcomes of treatment is the Beck Depression Inventory (BDI), which is a 21-item report measuring depressive symptoms. The BDI can be used intermittently throughout treatment (American Psychiatric Association, 1996). Treatment Options The first thing I would do is refer Ronald to a physician to have him taken off of Lotronex and changed to another medication that my better help with his colitis symptoms. For OCD. He is currently on Xanax and we would assess the helpfulness of that, while adding in Cognitive Behavior Therapy (CBT) to treat the OCD and Depression.