Reflective Case Study
Reflective Case Study
Objectives
1.
2.
3.
4.
Question
Further Questions?
Case presentation
She says she feels down most of the time, but much
less often she feels much better when she meets a
certain friend of hers.
Case presentation
Question
Case presentation
Question
PHQ-9 tool
Patient completes
PHQ-9 Quick
Depression
Assessment.
2.
3.
Add score to
determine severity
Drill
Question
http://www.adaa.org/about-adaa/press-room/facts-statistics
Anxiety:
GAD7
References:
Drill
Anxiety:
GAD7
References:
Intervention
Blood work was ordered for the patient including a CBC, CMP, Thyroid
profile, Vitamin D and B12 assays.
The choice of Escitalopram was based upon the fact that one of her
sisters had used it for depression and showed marked improvement.
Her blood work had shown a normal CBC ,a normal CMP, and a normal
endocrinology profile except for a vit. D of 12 ng/ml.
Question
Intervention 2
We decided to give the Escitalopram 4 more weeks on the same dose, with
continuation of psychotherapy sessions plus emphasis on the nonpharmacological treatment modalities such as:
Exercise
Diet
Sleep hygiene
Breathing exercises
Follow up 2 in 4 weeks
The Question!
2.
Reflection
3.
Influencing factors
4.
Learning
Feelings
I felt that depression was an immense burden on the patient and her
own household which generated the feeling of guilt she had, and I felt
also that the treatment itself will be more of a burden.
Vit. D and
depression
http://
bjp.rcpsych.org/conten
t/bjprcpsych/202/2/100
.full.pdf
PCOS
Depression is 4 times
more prevelant in
women without.
http://
www.ncbi.nlm.nih.go
v/pubmed/23728677
Contraceptives?
http://
onlinelibrary.wiley.co
m/doi/10.1111/j.1600-0
412.2011.01333.x/pdf
Evaluation
Conclusion
Suicide risk assessment should have been done in full as she also has a
probably family history of suicide (Father).
Contacting the OBGYN team following her condition would have added
valuable information and helped me enhance system based practice
competency.
Introduction
Depression is the most unpleasant thing I have ever
experienced. . . . It is that absence of being able to
envisage that you will ever be cheerful again. The
absence of hope. That very deadened feeling, which is
so very different from feeling sad. Sad hurts but it's a
healthy feeling. It is a necessary thing to feel.
Depression
is
very
different.
J.K. Rowling
Thank you.