A nurse is conducting a mental health assessment on a client. The client reports feeling extremely fatigued, having difficulty concentrating, and having thoughts of worthlessness. The nurse recognizes these as:

Choice A rationale:

Bipolar disorder involves both depressive episodes and manic episodes. The client in question denies any history of manic episodes, making bipolar disorder less likely as a diagnosis. Manic episodes are characterized by elevated mood, increased energy, impulsivity, and risky behavior.

Choice B rationale:

Dysthymia, also known as persistent depressive disorder, involves chronic feelings of sadness and a lack of interest or pleasure in activities. It is a milder form of depression that persists for at least two years in adults. The client's persistent feelings of sadness align more closely with the criteria for dysthymia.

Choice C rationale:

Substance-induced mood disorder occurs when the client's mood disturbances are a direct result of substance use or withdrawal. Since there is no mention of substance use or withdrawal in the client's history, this choice is less relevant to the scenario.

Choice D rationale:

Adjustment disorder is characterized by the development of emotional or behavioral symptoms in response to an identifiable stressor, and these symptoms typically resolve within six months of the stressor's resolution. In the scenario, there is no indication of a recent stressor, and the client's symptoms seem to be chronic rather than time-limited, making adjustment disorder less likely.

Choice A rationale:

Patient Health naire (PHQ-9). The PHQ-9 is a commonly used depression assessment tool that evaluates a patient's mood and depressive symptoms. It consists of nine questions that correspond to the nine criteria for diagnosing major depressive disorder (MDD) according to the DSM-5. The tool assesses various aspects of depression, such as mood, sleep disturbances, appetite changes, and more. It's a self-report questionnaire that helps clinicians assess the severity of a patient's depression and track their progress over time.

Choice B rationale:

Hamilton Depression Rating Scale (HAM-D). The Hamilton Depression Rating Scale (HAM-D) is another widely used tool for assessing the severity of depressive symptoms in patients with mood disorders. It contains multiple items that evaluate various aspects of depression, such as mood, feelings of guilt, suicidal ideation, and more. Unlike the PHQ-9, the HAM-D is typically administered by a trained clinician and is more extensive, making it suitable for clinical research and diagnosis but potentially less practical for routine screening.

Choice C rationale:

Beck Depression Inventory (BDI). The Beck Depression Inventory (BDI) is a self-report questionnaire designed to assess the presence and severity of depressive symptoms in individuals. It consists of 21 multiple-choice questions that cover various emotional, cognitive, and physical symptoms of depression. The BDI is useful for assessing the intensity of depression and changes in symptom severity over time. While a valuable tool, it's not the assessment tool most likely used in this scenario.

Choice D rationale:

Mini-Mental State Examination (MMSE). The Mini-Mental State Examination (MMSE) is not an appropriate tool for assessing depression. Instead, it's a brief cognitive screening test used to assess cognitive impairment and cognitive decline in individuals, especially in older adults. It evaluates aspects such as orientation, memory, attention, language, and visuospatial skills. It is not designed to assess mood, anxiety, or other emotional aspects related to depression.