Questions for Use before Diagnosis and the Assessment Tool Used
The case study of Alexia suggests that the Geriatric Depression Scale is an appropriate tool for assessing the depression that she has. Specifically, this tool was developed for the screening of depression in older adults (Anderson, Michalak, & Lam, 2002). The fact that Alexia is 32 years indicates that she is not a young adult. Therefore, the tool is suitable for her case considering that she has a history that points at indicators of depression. Using this tool, the following questions would be useful in determining if Alexia should be diagnosed with a depressive disorder according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5:
Are you of the idea that most individuals are better than you are?
Do you sometimes have feelings that you have a hopeless situation?
Do you feel that you are full of energy?
Do you feel that your situation makes you worthless?
Do you feel that it is good that you are alive now?
Are you of the opinion that you have challenges with memory than most people do?
Have you developed a preference to stay at home instead of going out and venturing into new things?
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Do you feel hopeless frequently?
Do you often feel happy?
Do you get bored frequently?
Do you always feel that your life is empty?
Have you given up on most of your interests and activities?
Do you have fulfillment with your life?
The DSM-5 Diagnosis
It is notable from the case study of Alexia that she is suffering from substance-induced disorder since her mood disturbances only relate to substance usage. Specifically, she experienced the mood disturbances six months after she had stopped using alcohol. It is also notable that she experiences the mood disturbances after she uses crack cocaine. The following diagnosis criteria are used in the diagnosis of the case of Alexia for substance-induced disorder:
The client’s response to the questions indicates that she experiences a persistent and prominent mood disturbance, which predominates in the clinical setting and is defined by a depressed mood as well as a remarkable reduced interest in most activities.
According to the case study of the patient, she indicates evidence from history of:
Symptoms of criterion 1 that is developed following substance intoxication and withdrawal, and
The substances that Alexia abuses are capable of producing the symptoms that are identified in criterion 1 above
The mood disturbances that the client experiences can only be explained by substance usage and they have been persistent for over a month after substance withdrawal as well as severe intoxication.
The mood disturbances do not happen exclusively at the time of a delirium
The disturbances in mood results in clinical significant impairment or distress in occupational and social functioning
Following the above diagnosis criteria and the case study of Alexia, the patient is diagnosed with the substance-induced depressive disorder in the following substances:
ICD-9-CM coding
292.84 cocaine use disorder with cocaine-induced depressive disorder, with onset during intoxication (APA, 2017).
291.89 alcohol use disorder with alcohol-induced depressive disorder, with onset during withdrawal
ICD-10-CM coding
F14.14 cocaine use disorder with cocaine-induced depressive disorder, with onset during intoxication
F10.14 alcohol use disorder with alcohol-induced depressive disorder, with onset during withdrawal (APA, 2017).
References
American Psychiatric Association (APA) (2017). Diagnostic and statistical manual of mental disorders: Fifth Edition . American Psychiatric Publishing, Arlington, VA.
Anderson, J. E., Michalak, E. E., & Lam, R. W. (2002). Depression in primary care: Tools for screening, diagnosis, and measuring response to treatment. British Columbia Medical Journal , 44 (8), 415-419.
