Adult Case
Fred, aged 42, approached his general practitioner (GP), claiming that he felt very tired for the past 4 months. He had sleeping difficulties, and he stated that he could not be bothered to shave (NHS, 2021). Fred appeared to be in a low mood, avoided eye contact, and had lost his usual jocular mood. The GP questioned Fred on his appetite and sleep patterns, which aimed at revealing any symptoms of depressive disorders. Changes in sleep characteristics and appetite may act as indicators of depression (Simmons et al., 2016). He then asked about his concentration to assess his psychological functioning. The GP finally questioned Paul on whether he had suicidal thoughts or had thought of harm or killing himself (NHS, 2021). Based on his answers, the GP informed Fred that he appeared to be moderately depressed, referred him to counseling, and set-up a follow-up appointment where Fred would be joined by his wife.
Child’s Case
If Fred was a child or an adolescent, the GP would have to ensure the family's involvement from the initial assessment. The involvement of the family is essential for the collection of objective data concerning the history of the patient and the family situation (Sadock et al., 2014). The general practitioner would also have to be more observant of the symptoms established, the impact of these symptoms on the patient and family, and any signs (such as psychomotor aggression) that require immediate intervention. The patient should have a supportive family for caregiving and providing comfort to reduce distress (Taylor et al., 2016). If adequate family or social support is not existent, then the patient would have to be maintained under hospital supervision to avoid exposing them to more harm.
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When working with an adolescent or a child, the main ethical consideration that would have to be considered is the ethical principle of confidentiality. While patients have a right for their information to be kept private, parents or guardians have to be provided with feedback concerning the emergency case of their child.
References
National Health Service (NHS). (2021). Common mental health problems: Clinical case scenarios for primary care. National Institute for Health and Clinical Excellence. https://www.nice.org.uk/guidance/cg123/resources/clinical-case-scenarios-pdf-version-pdf-181726381
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry. Philadelphia, PA: Wolters Kluwer.
Simmons, W. K., Burrows, K., Avery, J. A., Kerr, K. L., Bodurka, J., Savage, C. R., & Drevets, W. C. (2016). Depression-Related Increases and Decreases in Appetite: Dissociable Patterns of Aberrant Activity in Reward and Interoceptive Neurocircuitry. The American Journal of Psychiatry , 173 (4), 418–428. https://doi.org/10.1176/appi.ajp.2015.15020162
Taylor, R. J., Chae, D. H., Lincoln, K. D., & Chatters, L. M. (2015). Extended family and friendship support networks are both protective and risk factors for major depressive disorder and depressive symptoms among African-Americans and black Caribbeans. The Journal of Nervous and Mental disease , 203 (2), 132–140. https://doi.org/10.1097/NMD.0000000000000249
