Case Study Analysis

This case study analysis explores the mental state examination, DSM-5 diagnosis, and recovery from mental health disorders. It discusses the components of the mental state examination, identifies the symptoms of major depression disorder, and examines the stress-vulnerability model. Additionally, it delves into the principles of recovery-oriented mental health services, including empowerment and hope.

CASE STUDY ANALYSIS
Name of the student: Manila Wagle Ghimire
Student number: 18714018

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CASE STUDY ANALYSIS
Question 1:
The mental state examination or MSE can be described as the structured way that
includes observing as well as describing the current state of mind of the patient. This tool is
mainly used to analysis of the domains of appearance, behaviour, mood, and attitude, speech,
thought procedures, perception, thought content, insight and cognition (Santana et al., 2016).
One of the components of the MSE is mood and another component is affect. Both
mood and affect can be found to be related to emotion but they are not the similar things.
Affect is mainly seen to represent an immediately expressed as well as an observed emotion,
which is mainly seen to include the facial expression as well as the overall demeanour. Mood
on the other hand can be described as the sustained emotion that remains present for about a
prolonged period of time, which can actually cause alteration of the perception of an
individual about the world. One of the studies has specifically helped the nursing
professionals stating that affect is what is observed and mood is what is enquired from the
patient (Calvete et al., 2015). After analysing the component of “affect” present in the MSE
tool for Hanan, it was found that she was teary and even she was found to be hopeless about
her present condition. This denotes that she was sad and upset about her present situation. On
close analysis of her mood, it was found that she was filled with grief as well as loneliness
stating that her mood was actually low and depressed. Another component is thought-content,
which tries to find out whether patient has any abnormal thoughts and delusions. One study is
of the opinion that the concept of thought-content had tried to refer to the themes that occupy
the patients’ thoughts as well as their perceptual disturbances (Mitchell, 2017). Hanna had
been found to harbour suicidal thoughts where she tried to kill herself by overdose and this
exhibits her thought content and shows that she is having poor mental health and well-being.

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CASE STUDY ANALYSIS
DSM-5 can be explained as the taxonomic as well as diagnostic tool that had set
separate identification criteria for various types of mental health disorders (Elhai et al., 2015).
As per analysis of the symptoms of Hanan, it seems in the preliminarily that she might be
suffering from major depression disorder. The DSM-5 for depression mainly advises the
healthcare professionals to try to identify the presence of five or more symptoms from the list
of 8 symptoms during the same 2 weeks with the presence of at least one of the symptoms of
either depressed mood or loss of interest or pleasure from the activities she used to enjoy
(Fried et al., 2016). From the analysis of the case of Hanan, it has been found that she is teary
with moods of grief and loneliness, which point to the fact that she is suffering from
depressed mood. Some of the symptoms of depression mentioned in the DSM-5 that had been
noted in Hanan as well as depressed moods most of the times of the day, a slowing down of
the thought as she cannot decide how to handle her present situation alone with the three
children. She is suffering from recurrent thoughts of the day with recurrent suicidal ideation.
This can be found from the evidence where she had overdose of medications. She is also
suffering from fatigue or loss of energy every day as she had complained of tiredness. She is
also suffering from feeling of worthlessness and hopelessness, which is another symptom of
DSM-5. Hence, she can be stated to suffer from depression.
Question 2:
Often people who suffer from co-occurring disorders as well as family members often
raise several questions that are actually answered by stress-vulnerability model. This model
actually helps in understanding the main causes of different types of mental health disorders,
how the health issues take place and these disorders can be successfully managed (Calvete et
al., 2015). One study is of the opinion that this model mainly helps by acting as a guide to the
healthcare professionals and the family members by ensuring that the patient with the mental
disorder would have the best possible outcome (Moller, 2017).

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CASE STUDY ANALYSIS
The first critical factor is the biological vulnerability where it is stated that in order to
develop a psychiatric disorder, the individual must be having some biological or tendency to
develop the disorder. This vulnerability can be determined by genetic factors as well as early
biological factors (Hamilton et al., 2015). However, it must be remembered that biological
vulnerabilities are not limited to only the psychiatric disorders and might be including other
disorders. This may be seen to include cancer, arthritis as well as heart disorders.In the case
study, it has been seen that Hanan believes she is having breast cancer. It might happen her
health concern about being affected by breast cancer can result in developing depression in
her.
The second critical factor that also remains closely associated with this model is the
stress. Studies are of the opinion that stress affects vulnerability that can thereby trigger the
onset of the disorders and might cause worsening of the disorder (Wasserman & Sokolowski,
2016). Stress can be also found to be the response towards life situations where the individual
need to adapt or change. When individuals are not able to adapt to the stress, the psychiatric
symptoms might develop and get worsened. It has been found in the case study that she had a
large number of plans with her husband and their three children from starting to buy a new
house, promotion resulting in financial stability and living a happy and satisfied life.
However, she had lost him in an accident about three months ago and she had failed to cope
up with the grief and loneliness. She had developed a stress from the thinking of living life
alone with the responsibility of tending three little children. This had resulted in stress in her,
which might have resulted in depression in her.
Another critical factor is called the protective factors. They can cause reduction of the
biological vulnerability of the person as well as his stress. One such protective factor can be
medication that can help in lessening symptoms and lowering the relapses. Studies also opine
that good coping skills in the affected individuals as well as in the relatives as well as a

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CASE STUDY ANALYSIS
supportive environment can help in preventing stress from increasing symptoms (Le-
Boutillier et al., 2015).It can be found that Hanan is from Syria and she had no one to
socialise apart from her husband. Even her relatives and family members are in Syria who
cannot provide any social support to her in her crisis period. Lack of coping abilities in the
patient along with lack of social support from near and dear ones made her feel lonely ad
tried and this led to depression.
Question 3:
Recovery from mental health disorders can be described as the process of change
through which affected individuals can participate in improving their own health and
wellness, live a self-directed life and strive for reaching their full potential. Recovery can be
found to be based on both internal conditions experienced by affected individual who
describes their own selves in recovery including hope, empowerment, healing and connection
and even in external conditions that help in facilitating recovery like the implementation of
human rights, recovery oriented services and a positive culture of healing (Kidd et al., 2015).
Studies are of the opinion that principles of recovery oriented mental health services can help
in ensuring that the professionals should be delivering services in ways that support the
recovery of the mental health consumers.
Empowerment is an important aspect of recovery-oriented health care services where
healthcare professionals would be empowering patients in recognising that they can be at the
centre of decision-making process and thereby participate in their own care procedures. This
approach would make Hanan feel that she is capable in taking care of her own selves and this
approach would help her in developing a responsibility within herself to develop self-coping
and self-management skills. The professional attending Hanan should encourage her to
develop her strengths in fighting any barriers that she encounters and thereby overcome them

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CASE STUDY ANALYSIS
successfully to achieve recovery. The healthcare professionals need to support and empower
individuals in making their own choices about how they want to lead their lives and
acknowledged that the choices need to be meaningful and creatively explores (Waldemar et
al., 2015).
Another important aspect is hope. Studies are of the opinion that often patients
suffering from mental health disorders lose their hopes to live happy and successful lives.
This might be because of social stigmatisation about mental health issues, lack of zeal to
achieve goals, loss of close ones, social exclusions and many others, feeling of hopelessness
and worthlessness and others. Here, it is the responsibility of the mental health professionals
to instil hope about Hanan’s future and help her develop the ability to live a meaningful life.
Here, the healthcare professionals should be working with Hanan in positive and realistic
ways thereby helpingher to realise her hopes, goals and aspirations (Davidson, 2016).
The professionals should also provide respect to the patients firstly by listening to and
learning from and acting upon the communication from the individual and carers about what
is important to patient (Kidd et al., 2015). They should promote and protect the Hanan’s legal
citizenship and human rights. The professionals should ensure that they are courteous,
respectful and honest in all interactions with Hanan and be sensitive to her values, beliefs and
culture as he is from Syria. They should be respecting her autonomy and dignity, instil hope
in her to develop aspiration and potential to live quality future life and empower her to
develop strengths, self-coping abilities and self-management skills to overcome life stressors
and come out victorious.

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CASE STUDY ANALYSIS
References:
Calvete, E., Orue, I., &Hankin, B. L. (2015). A longitudinal test of the vulnerability-stress
model with early maladaptive schemas for depressive and social anxiety symptoms in
adolescents. Journal of Psychopathology and Behavioral Assessment, 37(1), 85-
99.https://doi.org/10.1007/s10862-014-9438-x
Davidson, L. (2016). The recovery movement: Implications for mental health care and
enabling people to participate fully in life. Health Affairs, 35(6), 1091-
1097.https://doi.org/10.1377/hlthaff.2016.0153
Elhai, J. D., Contractor, A. A., Tamburrino, M., Fine, T. H., Cohen, G., Shirley, E., ... &
Galea, S. (2015). Structural relations between DSM-5 PTSD and major depression
symptoms in military soldiers. Journal of Affective Disorders, 175, 373-
378.https://doi.org/10.1016/j.jad.2015.01.034
Fried, E. I., Epskamp, S., Nesse, R. M., Tuerlinckx, F., &Borsboom, D. (2016). What
are'good'depression symptoms? Comparing the centrality of DSM and non-DSM
symptoms of depression in a network analysis. Journal of affective disorders, 189,
314-320.https://doi.org/10.1016/j.jad.2015.09.005
Hamilton, J. L., Stange, J. P., Abramson, L. Y., & Alloy, L. B. (2015). Stress and the
development of cognitive vulnerabilities to depression explain sex differences in
depressive symptoms during adolescence. Clinical Psychological Science, 3(5), 702-
714.https://doi.org/10.1177/2167702614545479
Kidd, S., Kenny, A., & McKinstry, C. (2015). The meaning of recovery in a regional mental
health service: an action research study. Journal of Advanced Nursing, 71(1), 181-
192.https://doi.org/10.1111/jan.12472

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CASE STUDY ANALYSIS
Le Boutillier, C., Chevalier, A., Lawrence, V., Leamy, M., Bird, V. J., Macpherson, R., ... &
Slade, M. (2015). Staff understanding of recovery-orientated mental health practice: a
systematic review and narrative synthesis. Implementation Science, 10(1),
87.https://doi.org/10.1186/s13012-015-0275-4
Mitchell, A. J. (2017). The Mini-Mental State Examination (MMSE): update on its diagnostic
accuracy and clinical utility for cognitive disorders. In Cognitive Screening
Instruments(pp. 37-48). Springer, Cham.https://doi.org/10.1007/978-3-319-44775-9_3
Möller, H. J. (2017). New aspects of the vulnerability stress model in general, its relevance in
schizophrenic psychoses and the place of
antipsychotics.https://doi.org/10.1007/s00406-017-0825-7
Santana, I., Duro, D., Lemos, R., Costa, V., Pereira, M., Simões, M. R., & Freitas, S. (2016).
Mini-Mental State Examination: Screening and diagnosis of cognitive decline, using
new normative data. Acta Médica Portuguesa, 29(4), 240-
248.https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6889
Waldemar, A. K., Arnfred, S. M., Petersen, L., &Korsbek, L. (2015). Recovery-oriented
practice in mental health inpatient settings: A literature review. Psychiatric
Services, 67(6), 596-602. https://doi.org/10.1176/appi.ps.201400469
Wasserman, D., & Sokolowski, M. (2016). Stress-vulnerability model of suicidal
behaviours. Suicide. An unnecessary death, 27-37.https://books.google.co.in/books?
hl=en&lr=&id=_CMZCwAAQBAJ&oi=fnd&pg=PA21&dq=Stress-
vulnerability+model+of+suicidal+behaviours.+Suicide.
+An+unnecessary+death&ots=dN5DLN5oIP&sig=CmCb0ADqh7YnaZnM_w5zWao

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CASE STUDY ANALYSIS
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