course material

1. Depression and Somatization Disorders
Depression and Somatization DisordersHello Class,Group 1 is assigned Depression and
Somatization Disorders to further discuss. Failure to adjust and modify emotions
cognitively while experiencing stress can ultimately present an outcome of exaggerated
physiological and behavioral responses and amplify susceptibility to somatic disorders,
such as somatization (Davoodi, et al., 2019). Somatization Disorder is the presentation of
recurrent and multiple somatic complaints of several years duration for which medical
attention has been sought but which do not derive from a specific physical disorder (Swartz,
Blazer, & George, 2012).Please respond to the following questions:1. When caring for a
patient with somatization disorder, what therapeutic interventions would you formulate
(Allen, Woolfolk, Escobar, Gara, and Hamer, 2006)?2. How would you evaluate the success
of your interventions for a patient living with somatization?Depression is an extremely
serious mood disorder that effects how you think, feel, and act. Symptoms range from mild
to severe including, feeling sad, loss of interest or pleasure, change in appetite, trouble
sleeping or getting too much sleep, feeling worthless, difficulty concentrating, and thoughts
of death or suicide (American Psychiatric Association, 2021). To be diagnosed with
depression, symptoms must last at least two weeks and present a change in level of
functioning (National Institute of Mental Health, 2021).Please respond to the following
questions:1. After watching the short video, discuss what you’ve learned about depression
and has it changed your thoughts on what it is like to live with depression?2. What
interventions and resources would you use for this patient? How would you evaluate
success of treatment?3. What are a few ways to educate and reduce the stigma around
depression, so that individuals living with depression receive the help when symptoms first
present?Adolescents are experiencing depression at a rapidly growing rate and the use of
psychopharmacology and therapy has not slowed this increase (Henjie Blom et al., 2016).
Although there are many potential causes for this increase, one of the primary causes is the
increased prevalence of social media and its popular use amongst teens. Research has
shown a direct link between social media and depression and suicidality in adolescents
(Vidal et al., 2020). Though social medical has been linked to depression within this
population, just simply decreasing the use and frequency of social media can have a positive
impact and greatly decrease psychological distress (Radovic et al., 2017).1. What additional
non-pharmacological interventions would you recommend for the adolescent patient with
depression?2. Which medication would be the appropriate choice for this patient? What
important patient education would you provide?ReferencesAllen LA, Woolfolk RL, Escobar

2. JI, Gara MA, Hamer RM. Cognitive-Behavioral Therapy for Somatization Disorder: A
Randomized Controlled Trial. Arch InternMed. 2006;166(14):1512–1518.
doi:10.1001/archinte.166.14.1512American Psychiatric Association. (2021). What
isdepression? https://www.psychiatry.org/patients-families/depression/what-is-
depressioDavoodi, E., Wen, A., Dobson, K. S., Noorbala, A. A., Mohammadi, A., & Farahmand,
Z. (2019).Emotion Regulation Strategies in Depression and Somatization Disorder.
PsychologicalReports, 122(6), 2119–2136.Henje Blom, E., Ho, T. C., Connolly, C. G., LeWinn,
K. Z., Sacchet, M. D., Tymofiyeva, O., Weng, H.Y., & Yang, T. T. (2016). The neuroscience and
context of adolescent depression. Actapaediatrica (Oslo, Norway : 1992), 105(4), 358–
365.National Institute of Mental Health (2021). Depression.nRadovic, A., Gmelin, T., Stein, B.
D., & Miller, E. (2017). Depressed adolescents’ positive andnegative use of social media.
Journal of adolescence, 55, 5–15.Swartz, M. S., Blazer, D., & George, L. (2012). Somatization
disorder in a community population.American Journal of Psychiatry, 143, 1403–1408.Vidal,
C., Lhaksampa, T., Miller, L., & Platt, R. (2020). Social media use and depression
inadolescents: a scoping review. International review of psychiatry (Abingdon,
England),32(3), 235–253.Peer Post 1 (To be replied)Week 10 Assignment: Respond to
Group 1Jeffrey PhamNovember 2, 2021 1. When caring for a patient with somatization
disorder, what therapeutic interventions would you formulate (Allen, Woolfolk, Escobar,
Gara, and Hamer, 2006)?2. How would you evaluate the success of your interventions for a
patient living with somatization?Somatization disorder presents a challenge to healthcare
as the complaints of bodily distress have no objective or identifiable cause (Kumar & Jahan,
2020). The The intervention for this type of client should begin my ensuring that the
somatization disorders are distinguished from actual medical symptoms so that
intervention can be accurately implemented to address the problematic issues. According to
DSM-5, the diagnostic criteria for somatization disorder are as followed: somatic symptoms
are persistent and lasts longer than 6 months, one or more somatic distress symptoms that
cause significant impairment in functioning, and one or more excessive behaviors, thoughts
and//or feelings that is associated with somatic symptoms or associated with various
health problems (Henningsen, 2018). The severity of this disorder is on a continuum from
mild to severe, depending on the numbers of somatic complaints and on the DSM-5
diagnostic criteria; having multiple somatic complaints and having multiple DSM-5 criteria
met for somatization lead to more severe form of the disorder (Henningsen, 2018). To
manage this condition appropriately, first requires screening for it. The PHQ-15 is a
screening tool to detect for risk for somatic symptom disorder and have been demonstrated
to effectively screen and monitor for the disorder (American Psychiatric Association, 2013).
Antidepressants, such as Tricyclic has been demonstrated to have some moderate efficacy
over newer antidepressant in treatment of somatization while multimodal psychotherapy
program has been shown to significantly improve and manage somatic symptoms (Kumar &
Jahan, 2020; Henningsen, 2018). Interventions of somatic symptoms management can be
evaluated by using the PHQ-15 to initially screen for and then to evaluate for any
improvements in symptoms from baseline (Kocalevent et al., 2013). 1. After watching the
short video, discuss what you’ve learned about depression and has it changed your thoughts
on what it is like to live with depression?2. What interventions and resources would you

3. use for this patient? How would you evaluate success of treatment?Depressive symptoms
are associated with long duration and presence of sadness, irritability, or anhedonia
(Kaltenboech & Harmer, 2018). According to Stahl (2013) major depressive disorder is
formulated when a client has prolonged periods of depressed mood or loss of interest and
with greater or equal to at least 4 additional symptoms, such as suicidal ideation, sleep
disturbances, appetite changes, fatigue, guilt, and executive dysfunction. The development
of depression is complex, and neuro-research has related to abnormalities of certain
monoamines, which include serotonin, noradrenaline and dopamine, to the pathogenesis of
depression (Kaltenboech & Harmer, 2018). Brain imaging has shown that there is decreased
serotonin transmission activity in certain parts of the brain in depressive individuals while
increasing serotonergic activity by administering antidepressants help relieve those
symptoms and support the monoamine theory as relate to depression (Kaltenboech &
Harmer, 2018). Given the fact that untreated depression is associated with functional
impairment, such as poor quality of life and loss of work productivity and increased risks
for suicide, it is extremely important to treat depression (Culpepper et al., 2015).While the
goal of treating depression is to achieve full remission, the task begins by identifying
depression, administering treatment, and finally evaluating treatment response. There are
several tools available to aid in identifying and evaluating treatment response and/or
resistance, such tools include the 17-item Hamilton Rating Scale of Depression (HAM-D) and
the Patient Health Questionnaire-9 (PHQ-9) (Culpepper et al., 2015). While treatment
remission is considered less or equal to 7 score on the Ham-D and less than 5 on the PHQ-9,
full recovery is met when the client is in full remission though the treatment has been
discontinued (Culpepper et al., 2015).While the neurobiological monoamine theory of
depression includes a deficient or dysfunction in certain neurotransmitters, it is logical to
replace these neurotransmitters where it is impaired or deficient (Stahl, 2013). A group of
medications known as SSRIs can provide more of the neurochemicals in the synaptic cleft in
order to bind with the post-synaptic neurons to improve mood and depressive thoughts
(Stahl, 2013). While medications have been shown to effectively treat depression,
psychotherapeutic has been linked to increased resilience, improvements in mood and
physical and cognitive functioning (Eddington et al., 2017). While medications may be
helpful, some may benefit from psychotherapeutic alone or as an adjunct therapy to
medications.Additionally, Given the different profiles of antidepressants, when approach
with treatment option for an individual who has clinical depression, there are factors to
consider upon selecting the antidepressant medications, such as but not limited to
tolerability, current medicine with consideration for drug-drug interactions,
psychiatric/medical comorbidities, efficacy of prior treatments and cost of the medications
(Culpepper et al., 2015).3. What are a few ways to educate and reduce the stigma around
depression, so that individuals living with depression receive the help when symptoms first
present?The ways to educate and reduce the stigma around depression are to first
understand how stigma is defined and how it is socially constructed, and in what ways has it
created barrier to accessing care for depression. According to Stuart (2016), stigma is
created when there are several parts interacting: first a particular human is distinguished as
different; second, distinguished difference is attached to unwanted features, creating a

4. biased that apply to every person of that member; third, they are seen as different from the
dominant culture; fourth, the biased or stigmatized members are devalued and
systematically disadvantaged, creating a disadvantaged group that leads to their poor
health outcomes.There are several research and methods to help combat stigma in mental
health. Some of them include literacy education to improve education about mental health;
protest to object and denounce stigma, to attempt to change organizational behaviors;
advocacy to support strategies aim at tackling inequities designed by social structures that
limit rights of people with mental health issues (Stuart, 2016). These are just some
interventions that may be used to advocate for the mental health population.1. What
additional non-pharmacological interventions would you recommend for the adolescent
patient with depression?2. Which medication would be the appropriate choice for this
patient? What important patient education would you provide?Just as in adult, an
adolescence with mild to moderate depressive symptoms may benefit from psychotherapy
initially (Gautam, 2017). CBT and interpersonal therapy have been shown to be the most
efficacious for managing depression, however, the types of therapy that are most effective is
contingent upon how the client is responding (Gautam, 2017). In moderate to severe
depression, SSRIs are considered first line for treating children and adolescents’ depression;
specifically, fluoxetine has the most evidence for use in children and adolescents depression
and it is also FDA approved to treat children 8 years and older (Mullen, 2018).When
prescribing to this population, education regarding risk for triggering suicidal ideation must
be provided as there is an FDA black box warning to all antidepressants that it may increase
the risk for suicidal ideation in children, adolescents, and young adults (Mullen, 2018).