Reference no: EM133883051
Case
A 14-year-old girl comes to an intake appointment with a psychiatrist with a chief complaint of "I've been depressed recently." One year ago, she was raped by an unknown assailant in the parking lot of a grocery store, and, since that time, "things just have not been the same." She describes becoming irritable and angry with her parents for no apparent reason and feels disconnected from them emotionally. In fact, she feels "numb" most of the time, having "lost the joy from life." Her sleep is restless, and she is having trouble focusing on school and participating in the tennis team. She has nightmares about the rape in which the event is replayed. The patient admits that she has told very few people about the rape and tries "not to think about it" as much as possible. She avoids going anywhere near the location where the event occurred and remains anxious when shopping at a supermarket.
On mental status examination, her appearance, behavior, and speech are all unremarkable. Her mood is "depressed," and her affect is congruent and restricted. Her thought process is linear and logical. She denies suicidal or homicidal ideation, although wishes her attacker would "die a horrible death." She denies paranoia, delusions, or perceptual disturbances. Her cognition is grossly intact. Her judgment and impulse control are not impaired.
1. Discuss overview of the case, mental status exam with target symptoms, differential diagnoses, appropriate laboratory, diagnostic test or screening tools and treatment plan. Include rationales for each section of the treatment plan.
2. Describe the clinical presentation of depression in an infant and toddler.
3. Describe the clinical presentation of depression in school aged children or adolescents.
4. Discuss the diagnosis and treatment plan approach. Please locate ONE peer-reviewed article that provides rationale for the approach.