Case Study 2: Munny Kaew

Running head: CASE STUDY 2: MUNNY KAEW 1
Case Study 2: Munny Kaew
Student’s Name
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CASE STUDY 2: MUNNY KAEW 2
Case Study 2: Munny Kaew
Question 1
From the clinical signs that the patient is displaying, he seems to be suffering from
depression. This is a medical illness that negatively affects how one feels, thinks or acts. The
patient feels sadness and loss of interest in activities that he often enjoys. When assessing the
patient, it is important to rule out medical conditions like vitamin deficiency, brain tumor and
thyroid problems which also mimic depression. This is the reason why the DSM-5 criteria for
depression and the mental state examination are important in assessing the patient.
The mental state examination is a structured way of observing and describing the patient
current state of mind by focusing on appearance, behavior, attitude, mood, affect, speech,
thought process, perception, thought content and insight. According to Athanasos( 2017), MSE is
used to obtain a comprehensive cross-sectional description of the mental state which will be
combined with biographical and historical information that leads to a correct diagnosis and
formulation.
Athanasos( 2017) suggests that behaviour is a major element in establishing the mental
state of the patient. From the case the patient stares at the floor avoiding eye contact, and finally
asks the nurse to leave him alone. When at home, his wife indicated that he has lost interest in
the activities that he used to enjoy. This shows that there is something wrong since the behaviour
displayed here is not normal as per the explanations of the wife.
Mood and affect are also important elements that can be used to identify the mental
challenges faced by the patient. From the case his mood low since he has decreased interest in
activities that he previously enjoyed like caring for his children. His affect seems agitated as seen
in the way he asks the nurse to leave him alone. This shows that the patient is depressed and has

CASE STUDY 2: MUNNY KAEW 3
some thoughts which may be affecting his normal life. The mood can also be seen from his use
of monosyllabic words. This is also seen in the loss of interest in his life activities like family
and work due to the changes in his mood.
The Diagnostic and Statistical Manual of Mental Disorders V (DSM V) requires that the
patient must have at least five or more symptoms before being diagnosed as having depression.
Tolentino & Schmidt (2018) argue that when using the tool, to assess the patient, at least five
symptoms have to be identified from the condition of the patient for the case to qualify to be a
mental disorder. Munny is displaying the following signs which can indicate the presence of the
depression that qualifies for depression. The first sign is loss of interest and pleasure in normal
activities like his job and children which have been the most things that he enjoys. This is also
seen from the fact that he has been frequently taking sick leaves which did not happen in the
past. The second symptom is sleep disturbances which are seen from the fact that he sleeps too
much and spends most of his time in bed. The third is reduced appetite and weight loss which are
seen from the fact that he has lost his appetite since the incident at work. The fourth is the feeling
of guilt from the bereavement of his mother and the past failures of not taking care of him.
Lastly, Munny seems to be progressing to angry outbursts based on the fact that he was speaking
less and finally tells the nurse to leave him alone. Therefore, Munny seems to suffer from a
major depressive disorder based on the clinical signs that he portrays. Klein (2018) adds that this
type of depression usually happens after the symptoms persist for at least two weeks for the
symptoms to qualify as depressive. Therefore, from the DSM-5 criteria, the five signs can be
used to quantify that the patient is depressed.
Question 2