A man with severe depression is admitted to the partial hospitalization program for mood disorders after exhibiting unintentional weight loss and refusal to go to work

Question

He does not bathe or shave, sleeps poorly, and repeatedly states: "I'm useless, I'm no good to anyone.". Which intervention would be best to include in the patient's initial care plan? a. Involve patient in activities akin to those at his work to restore comfort.
b. Reinforce his interest in resuming work attendance when it returns.
c. Provide patient with nutrient-dense finger foods and weigh daily.
d. Provide activities that involve concentration and fine motor skills.

Answer 1

C
In this patient's initial treatment, it is important to focus on basic physiological functioning and safety concerns such as ensuring adequate nutrition. Therefore, interventions focused on basic functioning should be stressed in his initial care plan. Providing finger foods enables easier intake, and nutrient-dense foods require that the patient ingest less food while still maintaining his weight. Severely depressed persons have impaired cognition and would have difficulty with tasks involving concentration or fine motor skills. It is important to choose activities for which the patient would have a high likelihood of success (or a positive experience) in order to reduce failure and reinforcement of negative self-image. Reinforcing an interest in work is desirable but unrealistic for his initial care plan.