Sample Answer
Case Study: Nursing Care for an Individual with an Affective Disorder
Introduction and Rationale
This case study focuses on Sarah, a 35-year-old woman admitted to a community mental health service following a severe episode of major depressive disorder (MDD). Sarah was selected because she presented with complex biological, psychological, and social needs, and her care highlights the importance of person-centred, recovery-oriented nursing interventions in treating affective disorders. The case allows for exploration of nursing assessment, use of evidence-based practice, and the mental health nurse’s role in multidisciplinary and cross-boundary care.
Signs, Symptoms, and Causes of Affective Disorders
Affective disorders, commonly known as mood disorders, include major depressive disorder, bipolar disorder, and cyclothymia. Sarah was diagnosed with MDD, characterised by persistent low mood, anhedonia (loss of interest in activities), fatigue, feelings of worthlessness, sleep disturbances, and poor concentration. She also experienced passive suicidal thoughts.
The causes of affective disorders are complex and multifactorial, involving biological, psychological, and social factors. In Sarah’s case, she had a family history of depression, suggesting a genetic predisposition. Biologically, low levels of serotonin and dopamine may have contributed to her symptoms. Psychologically, Sarah had a history of low self-esteem and had recently experienced a relationship breakdown. Socially, unemployment and social isolation exacerbated her distress.
Nursing Assessment and Person-Centred Interventions
Assessment
A comprehensive nursing assessment was carried out using the biopsychosocial model and guided by the Nursing Process (assessment, planning, implementation, and evaluation). Tools such as the Patient Health Questionnaire-9 (PHQ-9) helped assess the severity of depression. Risk assessments were completed for self-harm and suicide, using the SAD PERSONS scale.
Biological Needs and Interventions
Sarah was prescribed SSRIs (Selective Serotonin Reuptake Inhibitors) to address her neurochemical imbalance. Nurses monitored medication adherence, side effects, and engaged in psychoeducation about pharmacological treatment. Sleep hygiene education and support with nutritional intake were also provided.
