Edgar Case Study
Question 1.
296.34 Major depressive disorder, Recurrent episode, Severe
(F33.3)
303.0 Alcoholic Intoxication, Without use disorder
(F10.929)
Other Factors:
v60.0. Housing problems (Potential loss of housing due to forgetfulness and now job loss)
(259.9)
V61.10 Relationship Distress with Spouse
(Z63.0) or Intimate Partner.
V62.29 Occupational problems
(Z56.9) (job loss).
Question 2.
Decision-making process
For major depressive disorder, there are three-stage criteria that qualify symptoms for the diagnosis of the condition.
- The patient should show 5 or more symptoms that are in tandem with the ones shown in the guidelines. Edgar’s symptoms are in tandem with the ones provided as follows; Edgar has recurrent thoughts of killing himself (1). This shows that the depressive episodes are current and he had once tried to kill himself by driving into a lake. Edgar has hypersomnia (2) and because of the oversleeping he has lost his job, so evidently, he has been oversleeping. Edgar also suffers from indecisiveness (3). This is shown by his inability to pay his mortgage for four months citing forgetfulness as a reason for defaulting. As a result, he is likely to lose his house. This reason is just not good enough and it looks inevitable that he will lose his house by the fact that he has recently lost his job. Further, Edgar has lost a significant amount of his body weight inadvertently, that is, despite not being on any weight loss program. According to the notes of the doctor, Edgar has lost interest in all activities (5). These are five symptoms that directly point to the condition of major depressive illness and they satisfy the first criterion of diagnosis.
- For an appropriate diagnosis of a major depressive disorder, the symptoms must cause clinically significant distress in social, occupational, or other important areas of functioning. Edgar’s symptoms fit this criterion in the following manner; his symptom of hypersomnia has manifested in his inability to wake up for the job. The implication of this is an occupational disaster, job loss. At a time when his mortgage bills are pending for four months, the loss of his job is the last thing he would have wanted. Due to these challenges facing him, his spouse has threatened to leave him, which is only likely to exacerbate his condition. His social challenges are there for everyone to see.
- The symptoms must not be attributed to the physiological effects of a substance or another condition. According to the medical records, Edgar neither has a medical condition nor is involved in the abuse of a substance that’s likely to cause the above symptoms.
Thus, Edgar’s case study fits this criterion for major depressive disorder. Since his mood state is severe and he has recurrent episodes, this diagnosis is accurate.
Alcoholic intoxication without use disorder is supported by the number of beers he takes per day, a massive increase to his previous number of bottles. Initially, Edgar used to take one to two bottles of beer per day. Later on, he massively increased his consumption to five to eight bottles of beer per day. He doesn’t take other drugs hence without use. His housing problems are unspecified as well as his job loss and relationship issues with his spouse.
Question 3
It was difficult to get the correct format for diagnostics bearing in mind that it has just been introduced. Therefore, it was important for me to have more time for gaining the appropriate experience and knowledge per the requirement. Once I have learned about the whole diagnostic process, then I would have adequate knowledge about it hence I would be able to carry out an accurate diagnosis. Further, the process was just time consuming and tiresome. However, it was easy to allocate the symptoms to particular disorders because various symptoms were mentioned in the case study.
Question 4
It’s imperative to note that more information is needed to code the diagnosis more accurately. For instance, the exact triggers of depressive episodes could be useful in diagnosis. In addition to that, since it has been relatively sometimes since the symptoms had started to show, had Edgar sought medical attention before? If he had, it would be helpful to know the kind of help he was offered and if there was a piece of key information for the current diagnosis to be done without any doubt.
On the other hand, concerning the enhancement of my general knowledge in the healthcare profession, I would like to enhance my education and training in the health care profession in the diagnostic process. This process is very important in ensuring that I acquire more skills and experience in my profession to improve my diagnosis knowledge and reduce errors in the diagnostic process. I would also like to know more about how to establish a team-based diagnostic process. I have realized that it is important for clinicians to partner with patients as well as their families throughout the process. Teamwork between patients, their families, and healthcare professions is key to make a timely and accurate diagnosis.