Major depression with poly-substance abuse - Assignment Example

He had emotional problems and would cry even for silly reasons according to his wife. He had no job, despite being a graduate. The last job he did was an year ago after which he did not try for any new employment. For the past one week, James ate very little food, was restless most of the times, had easy fatigability and complained of tiredness several times. He was brought to the hospital in view of deteriorating health status. On examination, James appeared dehydrated and confused. He appeared unhygienic, dirty and unattended.

he had poor oral hygiene. Pulse rate was 100 per minute, respiratory rate was 20 per minute, blood pressure was 130/90mmHg. He was afebrile. He had pallor and icterus. Systemic examination revealed tenderness in the right hypochondriac region. James was admitted to the psychiatric ward and investigations were sent. Complete blood picture revealed mild iron deficiency anemia, liver function tests were suggestive of acute hepatitis, urine analysis was suggestive of marijuana abuse. Ultrasound abdomen revealed acute fatty liver.

James has Major Depressive Disorder or MDD. The condition is a common mental illness that falls into the category of mood disorders. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV, 2000, diagnosis of MDD is made as in table-1. Depressed mood, irritability, low self esteem, feelings of hopelessness, worthlessness, and guilt, decreased ability to concentrate and think, decreased or increased appetite, weight loss or weight gain, insomnia or hypersomnia, low energy, fatigue, or increased agitation, decreased interest in pleasurable stimuli (e.g., sex, food, social interactions) and recurrent thoughts of death and suicide The importance of MDD lies in the fact that it causes considerable impairment in social functioning, role functioning, employment and physical health of the afflicted person (Wells et al, 1989).

Experts are of the opinion that depression is actually a