please paraphrase this paper tobe plagiarism free! This is a class in Womens Health in a Nurse Practitioner course.

Depressive disorders, are the leading burden of diseases in the world’s list according to the World Health Organization (WHO). Depressive disorders ranks high in developed country as opposed to the developing countries. Studies have indicated that the incidences of depression are increasing despite the fact that there are increased intensive researches being carried out and treatment being given out (Ripke et al., 2013). Mental health professionals determine how well to attend to these kinds of patients and the type of treatment to recommend depending on illness symptoms and the pathophysiology in particular. Individualized care is being prioritized as psychotherapeutic approaches, and antidepressant medicines are being administered to the patients. However, while attending to depressive disorder patients, determining the type of medications that will work best can sometimes be challenging.

1- Questions to include when interviewing a patient with Depressive Disorder.

While having a one on one session with a patient with depressive disorder, a mental health professional will need to focus on a number of questions. Introducing to patient and family member, asking about present and past medical history as well as addressing family issues are important aspects to consider. It is evidenced that different people get depressed and behave in different manners. The doctor may ask on how often one has felt down, stressed or hopeless to access the period of depression. The doctor can also ask if a person has ever had any thought of suicide. The answers will enable the doctor to ascertain the severity of depression. Asking question on sleep patterns is also significant because reduced sleep by at least 2 hours or sleep disturbances is an indication of immense depression. Also, asking if one prefers being alone or doing things with other people will enable the doctor to spot on withdrawal behaviors which is a common characteristic of depression. Examples of important questions are:

· How are you feeling lately?

· How is your overall health?

· Could you let me know if you have any medical problems or allergies?

· Could you let me know your family history?

· How are you feeling at work/school?

· Are you eating and sleeping well?

· Describe a typical day

· How is your mood?

· Who do you live with?

· Do you have pets?

· Do you suffer from fatigue and lack of energy lately?

· How that affects your life?

· What do you do as exercise in a typical day?

· Tell me about your social/leisure activities?

· Do you have a sexual partner?

· How is your sexual activity?

2-Clinical findings that may be present in a patient with Depressive Disorder.

A depressive disorder is clinically manifested as DSM-IV-TR, which is a criterion for the symptoms. The main clinical presentations include emotional distress such as sadness or depressed mood and neuro vegetative symptoms, which involves lack of energy, loss of appetite and sleep, weight loss, insomnia and bipolar disorder. Neuro- vegetative symptoms differ with gender in that women are more likely to experience this symptom compared to men who are characterized by irritability. Diagnostic studies for these patients include; physical examination, lab tests, psychiatric evaluation and DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) (Uher et al., 2014). This diagnostic measure is all significant because they will determine the severity of depression and the type of medication to be recommended. Examples of symptoms of depression are:

· Fatigue

· Lack of concentration

· Lack of energy

· Insomnia

· Irritability

· Hopelessness

· Helplessness

· Poor appetite

3-Diagnostic studies that should be ordered on this patient

· CBC to rule possible anemia- will aids to assess if hemoglobin levels are in normal limits (patient is suffering fatigue and irritability)

· Thyroid Function to rule out hypothyroidism (patient is obese and has being suffering symptoms of fatigue and irritability)

· Hemoglobin A1C (close family members with history of diabetes)

4- Possible differential diagnoses for this patient

The main differential diagnosis for depressive disorder patients ate syndrome and etiologic and psychiatric. Syndrome diagnosis entails the fitting of one’s depressive symptoms with the immediate syndromes for instance if one is bereaved, then the depression will be associated with normal grief. Etiological diagnosis focuses on the cause of specific incident of depression. Causative agent for this disorder can be neurological or a substance abuse. Psychiatry diagnosis is caused by a number of comorbidity disorders such as eating, personal; sleep cognitive, anxiety and somatoform (Maughan, B., Collishaw, S., & Stringaris, A., (2013).

Major Depressive Disorder: Evidenced by anhedonia, changes in appetite, weight gain, insomnia, irritability, withdrawn, isolation, lack of energy, and screenings results.

Hypothyroidism: Evidenced by 15 lbs. gained in the midsection, mood swings, irritability, and fatigue.

Anemia: Evidenced by fatigue, lack of concentration, insomnia, tachycardia, and dyspnea.

5-Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups. Please make sure that references are not older than 5 years.

For management of depressive disorder patients, an extensive range of treatment is available. Medication treatment requires a 2-12weeks therapeutic dose, the medicine is prescribed by a qualified physician and adherence are highly needed. Psychotherapy and cognitive behavior therapy can also aid in relieve of this burden. Pharmacotherapy by its own is said to be insufficient, hence when all this is combined, and patients educated on their mental health and follow-ups were made, it is proved that the likelihood of getting positive results is immeasurable (World Health Organization, 2014).


Maughan, B., Collishaw, S., & Stringaris, A. (2013). Depression in Childhood and Adolescence. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 22(1), 35–40.

Ripke, S., Wray, N. R., Lewis, C. M., Hamilton, S. P., Weissman, M. M., Breen, G., & Heath, A. C. (2013). A mega-analysis of genome-wide association studies for major depressive disorder. Molecular psychiatry,18(4), 497-511.

Uher, R., Payne, J. L., Pavlova, B., & Perlis, R. H. (2014). Major depressive disorder in dsm‐5: implications for clinical practice and research of changes from DSM‐IV. Depression and anxiety, 31(6), 459-471.

World Health Organization. (2014). Management of Substance Abuse Unit. Global status reports on alcohol and health.


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