Case #17 Part 2

Final Diagnosis

While Mr. Bender did demonstrate some symptoms of depression following his appendectomy and also following the birth of his son, you are not certain if he met the criteria for MDD during those times. However, you recall that at one point his physician felt he required medication for his insomnia. You discuss the options of maintaining Mr. Bender on his SSRI versus discontinuing the SSRI with close follow-up. You ask Mr. Bender to retake the Zung Questionairre to objectively measure his depression, and he scores in the normal (i.e., “no depression) range. He opts to taper and discontinue the SSRI, and agrees to see his counselor twice a month.

You review the *SIG E CAPS symptoms of depression with Mr. and Mrs. Bender, and instruct them to follow-up with you if either of them notices a return of any *SIG E CAPS symptoms. Both Mr. and Mrs. Bender are pleased with the plan at this point. As they leave the exam room, you remind Mr. Bender to call your office if he has any questions, and wish him good luck at his upcoming basketball game.

For more information on depression:

National Foundation for Depressive Illness, Inc.
P.O. Box 2257
New York, NY 10116
Telephone: 1-800-248-4344
Internet: http://www.depression.org

National Depressive and Manic-Depressive Association
730 N. Franklin St.
Suite 501
Chicago, IL 60610-3526
Telephone: 1-800-826-3632 or 1-312-642-0049
Internet: http://www.ndmda.org

National Mental Health Association
1021 Prince St.
Alexandria, VA 22314-2971
Telephone: 1-800-969-NMHA (969-6642)
Internet: http://www.nmha.org

Sources:

Alternate-Site Anesthesia: Clinical Practice Outside the Operating Room. Garfield B. Russell, M.D., editor. Chapter 13, Donald E. Martin and Paul Kettl. Butterworth-Heinemann.

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR). American Psychiatric Association, 2000.

Diagnosis and Management of Mood Disorders. American Academy of Family Physicians Monograph. 2004.

Essential Psychopharmacology, Neuroscientific Basis and Practical Applications. Stephen M. Stahl, MD, PhD. Cambridge University Press, 2000.

Handbook of Psychiatric Drug Therapy. Third Edition. Steven E. Hyman, George W. Arana, Jerrold F. Rosenbaum. Little, Brown and Company, 1995.

Interview Guide for Evaluating DSM-IV Psychiatric Disorders and the Mental Status Examination. Mark Zimmerman, M.D. Psych Products Press, 1994.

Kaplan and Sadock's Synopsis of Psychiatry. Eighth Edition. Harold I. Kaplan, M.D. and Benjamin J. Sadock, M.D. Williams and Wilkins, 1998.

Massachusetts General Hospital Handbook of General Hospital Psychiatry. Fourth Edition. Ned H. Cassem, Theodore A. Stern, Jerrold F. Rosenbaum, Michael S. Jellinek. Mosby, 1997.

Physician’s Desk Reference. Fiftieighth Edition. Thomson PDR. 2004.

Psychopharmacology of Antidepressants. Stephen M. Stahl, MD, PhD. Martin Duntz, Ltd. 1998

Treating Depression in Primary Care, A Special Report. Postgraduate Medicine. McGraw-Hill Companies, Inc. 2003.

Authors:

Case composed: October 2000
Revised and updated: April 2005

Case Composer:

Michael S. Lehman, M.D.
Instructor, Department of Psychiatry, Penn State College of Medicine
Graduate of Penn State College of Medicine, Class of 1999

Reviser/ Editor:

Michael P. Flanagan, M.D., FAAFP (April 2005)
Assistant Professor of Family and Community Medicine,
Penn State College of Medicine

To guide us in the development of case studies to meet your educational needs, please take a few minutes to complete a brief survey.  

Email Case



Penn State Milton S. Hershey Medical Center ©2004
This page was last updated on April 24, 2006
Contact Us