NRNP 6635 Week3 Assignment
NRNP 6635 Week3 Assignment
Week 3: Mood Disorders
While most people experience the sadness or grief at some point in their lives, it is typically of short duration and may occur in response to some type of loss. Clinically significant depression, on the other hand, is more disruptive and serious. It lasts longer and has more symptoms that interfere with daily functioning.
This week, you will explore the differences among mood disorders such as depressive, bipolar, and related disorders, and you will examine challenges in properly differentiating among them for the purpose of accurately rendering a diagnosis. You also will look at steps that can be taken to increase the likelihood that patients who are diagnosed with these disorders benefit from treatment and refrain from physically harming themselves or others.
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Learning Objectives
Students will:
- Apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information
-
Formulate differential diagnoses using
DSM-5
criteria for patients with mood disorders across the lifespan
Learning Resources
-
Required Readings
(click to expand/reduce)American Psychiatric Association. (2013). Bipolar and related disorders. In
Diagnostic and statistical manual of mental disorders
(5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm03American Psychiatric Association. (2013). Depressive disorders. In
Diagnostic and statistical manual of mental disorders
(5th ed.).Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015).
Kaplan & Sadocks synopsis of psychiatry
(11th ed.). Wolters Kluwer.- Chapter 8, Mood Disorders
- Chapter 31, Child Psychiatry (Section 31.12 only)
Document:
Comprehensive Psychiatric Evaluation Template
Document:
Comprehensive Psychiatric Evaluation Exemplar
-
Required Media
(click to expand/reduce)Classroom Productions. (Producer). (2015).
Bipolar disorders
[Video]. Walden University.
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00:00:00
BEGIN
Transcript
:
00:00:00
DIAGNOSING MENTAL DISORDERS
00:00:00
DSM-5® AND ICD-10
00:00:05
BIPOLAR DISORDERS
00:00:10
MERLIN HUFF
Can we take a trip? Will you go somewhere? Its been a long time since youve had a vacation.
You want some coffee?
00:00:15
HANNAH HUFF
Umm oh, Im good. Im good.
00:00:15
MERLIN HUFF
All right.
Is that charged?
00:00:20
HANNAH HUFF
Yeah. Yeah.
00:00:20
MERLIN HUFF
You should keep it charged. You should always keep it charged. If the battery runs down too many times it will actually go (inaudible
).
00:00:25
HANNAH HUFF
Oh, great.
00:00:25
MERLIN HUFF
Youre sure, you dont want some coffee?
00:00:30
SEAN HARRIGAN
Recent studies have shown that our happiness and sense of wellbeing have as much to do with our approach to the world,
as they do with external situations.
Just as we are influenced by our circumstances, our thoughts, feelings, and mood,
shape how we perceive those circumstances, affecting our sense of contentment.
But what happens when our mood itself feels out of control,
when it seems depressed, erratic, hijacked by chemical imbalance
that feel impossible to manage? This is the experience faced by those
with bipolar and related disorders, which are mental disorders characterized
by abnormalities in an individuals mood.
Mood is defined as the prolonged emotions that color a persons perceptions of the world.
Within this category of mood disorders are two groups of disorders.
These are depressive disorders, and bipolar and related disorders.
Both groups of disorders involve abnormalities of mood.
However, while depressive disorders are marked by major depressive episodes
or symptoms characterized by low mood and loss of interest in usual activities,
bipolar and related disorders feature manic or hypomanic episodes
or symptoms, in which the individual has an elevated,
expansive, or irritable mood. Bipolar and related disorders
can be cyclical in nature, with the individual experiencing episodes of
sorrow and depression, followed later by periods of excessive energy,
potentially making their mood and thus their lives feel unpredictable and chaotic.
00:02:15
DSM-5® AND ICD-10 CODING
00:02:20
SEAN HARRIGAN
The chapter on bipolar and related disorders grouping
in the fifth edition of the Diagnostic and Statistical Manual disorders
or DSM-5 contains a number of distinct disorders,
each given its own diagnostic code. All DSM-5 codes crosswalk
to the corresponding codes used by the World Health Organization
in the International Classification of Diseases or ICD.
In DSM-5, each disorder is first linked to the coding system
from the ICD-9, with the codes for the ICD-10 listed
in parentheses after. For instance, Bipolar I disorder
with the current or most recent episode manic and of mild severity
is assigned the code 296.41 from ICD-9
and F31.11 in parentheses from ICD-10.
This is because the ICD-9 system was still in use in the United States
when DSM-5 was first released. ICD-10 was adopted
in the US in the fall of 2015.
However, because ICD-10 was implemented in 2015, this program will be listing
the newer code from the ICD-10 first, followed by the
ICD-9 codes in parentheses. Bipolar disorder is often referred to
in the literature as Bipolar Spectrum. Included in this spectrum are
Bipolar I and II disorders. Bipolar I disorder contains
four broad coding specifications, each of which is dependent upon the
nature of the most recent episode. The codes can further be delineated by descriptors
that indicate severity and the presence or absence of psychotic features.
Further, additional specifiers can indicate if the disorder is in remission
or if it is unspecified. Sometimes when relevant we will also
delineate the ICD-9 and 10 codes when we mentioned a disorder from one of the
other chapters of DSM-5. For example, to use one of the depressive disorders
mentioned earlier in this program, Major Depressive Disorder, Single Episode,
Mild is coded as F32.0 (296.21),
part of the F30 to F39 section of ICD-10
on mood affective disorders. Organizationally, there are some differences
between the layouts of DSM-5 and ICD-10. ICD-10 contains
a classification known as Bipolar Affective Disorder in their larger section
on Mood Affective Disorders. This larger section on mood disorders
is contained in the F30 to F39 block of ICD-10.
In addition, many of the bipolar and depressive disorders that are separated in DSM-5
are lumped together in ICD-10. For example, Cyclothymia,
which is listed as a Bipolar Related Disorder in DSM-5,
and Persistent Depressive Disorder (Dysthymia), previously known as dysthymic disorder
are both placed in the F34 section of the ICD-10,
for Persistent Mood Affective disorders.
While the ICD-10 grouping of all mood disorders into one section may seem like a minor organizational difference,
it speaks to the historical association of these disorders
as mood disorders in DSM-IV-TR and affective disorders
in DSM III. Two other differences between ICD-10 and DSM-5
are with substance or medication-induced bipolar disorder and bipolar disorder
due to another medical condition. The ICD-10 puts what they call
mental and behavioral disorders due to psychoactive substance abuse
in the F10 block. And organic, including symptomatic mental disorders
in F00 to F09. Specifically, F06
or other mental disorders due to brain damage and dysfunction and to physical disease.
In this case, the code is F06.3 for
Organic Mood Affective Disorder. We cover these organizational differences in greater detail
in the first program of the series. NRNP 6635 Week3 Assignment
00:06:50
MOOD EPISODES
00:06:55
SEAN HARRIGAN
Most mood disorders are made up of specific mood episodes.
A mood episode is a specific period of time where an individual feels abnormally energized
and elevated, or depressed. The most recent episode
the individual experienced affects the coding of the disorder. Beyond coding,
an understanding of the type and frequency of mood disorders experienced
by an individual patient is necessary in order to make an appropriate diagnosis.
Because of this, we will first define each of the
three mood episodes, manic, hypomanic, and major depressive.
We will then explain the pattern by which these episodes present in
specific mood disorders before exploring how the presence of these episodes can lead the caregiver
to an overall diagnosis.
00:07:50
MOOD EPISODES
00:07:50
Manic
00:07:55
SEAN HARRIGAN
A manic episode is a required factor in making a diagnosis of Bipolar I disorder, which well look at later in the program.
The mood of an individual experiencing a manic episode is
abnormally elevated, expansive, or irritable. The patient may seem
energetic and could have an intense fixation on a goal
or other activity. These symptoms affect the individual for most of the day,
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