Mental Health Care Disparities: Examining Uneven Distribution of Psychiatric Disorders - Research Paper

Introduction

Generally, depression, as well as substance use complications, are among the most common and unbearable psychiatric disorders affecting people across the globe. However, the impacts of these psychiatric disorders are unevenly distributed. Typically, mental health care disparities are referred to as the difference in treatment given to the members of different ethnic or maybe racial groups, which has not been approved by the necessary conditions of health or the treatment preferences of the patients (Arcangelo et al., 2017). For instance, members of the ethnic minority group in American society, the Black Americans are more likely than the white ethnic group to suffer from the depressive complications under-determined or maybe under-treated. In comparison to the whites with depression disorder, Black Americans are less likely to fill the antidepressant instructions.

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Three Questions for the Patients

Immediately after evaluating the material presented in this particular case study of the patient, there exist some essential questions concerning this patient's psychiatric historical background. Therefore, some of the additional items include:

After every discontinuation of the medication process after the depression episode, was this decision the leading choice of the physician or maybe self-initiated? Overall, this given question would help in providing elaborate knowledge of the patient's compliance with the medication process. For instance, has the patient stop taking medication as prescribed by the doctor on various symptoms are examined.

What were the circumstances before each episode of depression? This question would explain to the medical practitioner on the several triggers as well as factors that individually affect the patient before the occurrence of the depressive episode.

There emerges to be a history of alcohol abuse as well as depression in your family has anybody in your family sought and received adequate treatment? In general, question three would give a good view of the patient's understanding of psychiatric treatment. Because this patient does not believe in the process of psychotherapy due to some religious reasons, the patient may be unaware of what treatment, which was, are or maybe will be readily available to him.

Feedback From Individuals in the Patient's Life

Statistically, this patient is 33 years old in marriage. Supposing his wife is around even before, during as well as after the depressive episode, she may help in giving adequate information that the patient failed or refused to share regarding his illness. Therefore, the first individual to get questioned would be his wife (Arcangelo et al. 2017). Similarly, some of the questions directed to the patient's wife would consist of the start of the depressive symptoms. What exactly happens before the occurrence of each depressive episode? Is there any form of conflict between you and your husband? Are there any stressors, like the financial constraints existing between your husband and you?

Moreover, the patient also has three teenagers. All three of his young ones are also suffering from some types of depressive illness. Hence, questioning a patient's teenagers may give an elaborate historical background of the patient. For instance, the teenagers may have noticed some symptoms causing the depression of the patient some times back. The questions for the patient's children consist of, did your parents frequently argue while you were growing up? Did your father ever lose interest in your childhood periods? Did you feel loved or some rejection from your father while growing up? What were the behaviors of your father? Did you ever notice any form of alcohol or drug abuse from your father while growing up?

Physical and the Diagnostic Exams for the Patient

Surprisingly, there is not any test for depressive disorder. The main objective of the physical examination, as well as the diagnostic testing, would help in ruling out other conditions leading to the same depressive symptoms. Typically, a given physical examination should be done to assess the respiratory as well as cardiovascular systems. Essential signs and symptoms should also be observed and taken, as well.

Similarly, the patient should be assessed in specific medical laboratories (Ball et al. 2018). The medical officer should effectively examine the thyroid levels of the patient. Consequently, thyroid hormones have considerably been connected to depression disorder. Hence, as a result, depression disorder can be caused by the underactive or maybe overactive thyroid.

Similarly, another laboratory test to consider is the dexamethasone suppression test. Well, this given test examines the negative influence of dexamethasone in the human body. Once provided with dexamethasone (Targum, 2016), in a relatively small dose, the levels of cortisol decrease in healthy adults, but may remain raised in a depressed patient.

Additionally, several depressive disorders have been connected to specific inflammatory biomarkers. The patient's blood test examines about nine biomarkers including, alpha-1antitrypsin, BDNF, epidermal growth factors, prolactin, soluble tumor necrosis factor type II, apolipoprotein CIII, myeloperoxidase as well as resin. Thus, these particular biomarkers represent both inflammatories as well as metabolic pathways related to the depression disorder.

Three Differential Diagnoses for the Depressed Patient

Concerning the various symptoms outlined by the depressed patient, there are several diagnoses this particular patient could be suffering from. First, the Recurrent Major Depressive Complication with some melancholic elements, and it is a diagnosis which is due to the patient's main depressive symptoms, like depressed mood in most parts of the day, high rate of anxiety, as well as suicidal thoughts (Stahl, 2018). Second, the specific melancholic elements are usually based on the patient's signs and symptoms, becoming worse in the morning hours, the inability to function as well as lack of pleasure effectively. Finally, the other diagnoses for this given patient involve thyroid imbalance or maybe the panic disorder.

Prescriber's Guide and Medications for the Patient

Unfortunately, because this particular patient has become more resistant to the first line as well as second-line drug therapy processes for depression, the medical practitioner should start providing the patient with the Phenelzine as well as MAOI drugs. The patient should take about 45 milligrams of Phenelzine daily (Ball et al. 2015), divided into three distinct doses for the whole day. Again, another proposal for this depressed patient would be Isocarboxazid medication. Its dosage would begin at 10 milligrams of the BID. And if therapeutic response becomes successful, this particular medication should be gradually decreased without affecting therapeutic intervention. For those patients suffering from cardiac complications like atrial fibrillation, they should take Phenelzine medication to reduce the rate of cardiac arrests.

Lessons Learnt From the Case Study

In general, several lessons have been learned in the entire case study. Firstly, the experience of medical compliance was well learned. Secondly, people learned about practical medication choice in a depressed patient, particularly after the recurrent episodes of depression. Lastly, people were able to learn more about assessment as well as the presentation of the psychiatric treatment for the patients.

Conclusion

Overall, this particular case study involves a sixty-three-year-old male patient with persistent depressive disorder. The patient has gone through success as well as failures with the medication as well as treatment. Therefore, these failures may be a result of medical incompliance or maybe inappropriate termination of the medicines from the practitioner. Surprisingly, the patient is, at last, improving appropriately. I hope this improvement will continue until the patient gets full recovery.

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Female genitalia. Seidel's Guide to Physical Examination. 8th ed. St Louis, MO: Elsevier Mosby.

Stahl, S. M. (2018). Essential Psychopharmacology Online. Retrieved September 11, 2018, from https://stahlonline-cambridge-org.ezp.waldenulibrary.org/prescribers_drug.jsf?

Targum, S. D. (2016). Identification and treatment of antidepressant tachyphylaxis. Innovations in Clinical Neuroscience, 11(24), 3-4. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008298/