NRNP 6635 Assignment: Assessing and Diagnosing Patients With Mood Disorders

Subjective:

CC (chief complaint): Allegations by the patient’s mother that the patient recurrently gets moody this time of the year every year.

HPI: Ms. Julie Houston is a 19-year-old female who came to the psychiatric clinic for assessment following a recommendation from her mother. The patient presented with allegations by her mother that she recurrently gets moody around this time of the year annually. She reports that she is not feeling great and feels down. She admits to not doing so well, especially with her special business program in school. She reports that she comprehends everything but the classes are boring. She feels the teachers are stressing her with projects such as developing a mock company which she is finding difficult to complete. Two of the projects are already long overdue. The patient reports difficulty concentrating. For instance, she can read newspaper headlines and cannot seem to recall them almost immediately, a similar case with her classes. The patient has recently gained weight approximately ten pounds. She is experiencing excessive daytime sleepiness to an extent of sleeping through five of her classes this month. Initially, the patient was social, and easily made a lot of friends with whom she enjoyed their company. She would attend concerts and shows with them and engage in fun activities. However, lately, she finds them annoying, and dull and avoids their company. She currently prefers staying indoors alone which she partly attributes to the cold weather. She expresses her dislike for fall and winter because she cannot engage in activities such as going to the beach and riding in convertibles which she usually does during summer. She associates winter with darkness, and misery as opposed to beauty during summer.

Past Psychiatric History:

  • General Statement: The patient denies any past psychiatric treatment.
  • Caregivers (if applicable): Her parents.
  • Hospitalizations: The patient has never had any psychiatric admissions.
  • Medication trials: She is not on any medication trials.
  • Psychotherapy or Previous Psychiatric Diagnosis: The patient has never been diagnosed with any psychiatric disorder or undergone psychotherapeutic interventions.

Substance Current Use and History: The patient denies any history of or current substance abuse or abuse by any member of her family.

Family Psychiatric/Substance Use History: There is no history of any psychiatric condition in her immediate or extended family.

Psychosocial History: The patient grew up in South Carolina and was raised by both her parents. She has three other siblings, two brothers, and one sister. She is currently a full-time student undertaking a business undergraduate program in Boston. She stays with two other female student roommates in off-campus housing. She is unemployed, has never been married, and not dating. She has no history of legal issues or trouble with the authorities.

Medical History: The patient has never been admitted for any medical treatment.

 

  • Current Medications: She is not on any prescription medication for any medical condition.
  • Allergies: She has no known allergies to drugs or drugs.
  • Reproductive Hx: Her menarche was at fourteen years. She experiences a regular menstrual cycle. Her last menstrual period was 20 days ago. She is not currently gravid. She has never used any contraceptives and has no children.

ROS:

  • GENERAL: The patient reports no weight loss but a recent weight gain, no fever, and no generalized weakness.
  • HEENT: There is no vision loss, hearing loss, dysphagia, sore throat, or nasal congestion.
  • SKIN: The patient denies pruritus, skin rash, or abnormal skin changes.
  • CARDIOVASCULAR: There are no reported palpitations, easy fatigability, shortness of breath even on exertion, chest pain, or edema.
  • RESPIRATORY: There is no difficulty in breathing, no chest pain, and no cough.
  • GASTROINTESTINAL: The patient denies experiencing anorexia, abdominal pain, nausea, vomiting, diarrhea, or constipation.
  • GENITOURINARY: Patient reports no pain or discomfort on urination, blood in urine, increased frequency, or incontinence.
  • NEUROLOGICAL: The patient denies headaches, dizziness, numbness, convulsions, weakness, or paralysis.
  • MUSCULOSKELETAL: There are no myalgias, no joint swelling, pain, or stiffness.
  • HEMATOLOGIC: The patient denie

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