Major Depressive Disorder (MOOD & AFFECT) RAPID Reasoning


Prepare students to clinically reason by recognizing RELEVANT clinical data and set correct PRIORITIES when a patient presents with major depressive disorder.


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This Case Study Begins with the Following Scenario:

Marilyn Smith is a single, African American 28-year-old female who presents to the emergency department with complaints of “feeling crummy” for the past six months.  She reports that she no longer feels like doing any of the things she used to enjoy. “It all seems so pointless.” 

She can’t even bother to eat most days and has lost weight recently.  Although she has no energy, she finds it difficult to both fall sleep and stay asleep.  Even when she does manage to fall asleep, she never feels rested when she awakes.  She reports having difficulty at work as a computer support person because it is so hard for her to concentrate.

Last week she called in sick and spent the day in bed crying off and on all day.  Last night she found herself crying again and this time she also thought about suicide, which scared her and prompted a visit to the ED. “I don’t want to live like this anymore.  I feel like I will never be happy again.”

Concepts (in order of emphasis)

  1. Mood and Affect
  2. Stress
  3. Coping
  4. Clinical Judgment

Three Complementary Bonuses!

  1. Faculty users guide to successfully implement this active learning tool in your program!
  2. SBAR template. Use this to add and practice SBAR with this scenario!
  3. QSEN/concept based questions in Word doc. Integrate concepts and QSEN competencies into this case study! Several questions related to the primary concept and each QSEN category that can be edited to create a supplement for this case study.

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