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**files (1)** – ## CASESTUDY4.docx **## CASESTUDY4.docx** CASE STUDY 4: Depression, Anxiety, Substance Use, and Chronic Pain **CASE STUDY 4 – Depression, Anxiety, Substance Use, and Chronic Pain** **Case Scenario** Ms. R.D. is a **45-year-old female** presenting with insomnia, fatigue, chronic low b…
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**files (1)**
– ## CASESTUDY4.docx
**## CASESTUDY4.docx**
CASE STUDY 4: Depression, Anxiety, Substance Use, and Chronic Pain
**CASE STUDY 4 – Depression, Anxiety, Substance Use, and Chronic Pain**
**Case Scenario**
Ms. R.D. is a
**45-year-old female** presenting with insomnia, fatigue, chronic low back pain, and mood changes.
**History**
· PMH: Chronic pain, prior opioid exposure
· Reports alcohol use nightly
· PHQ-9: 17, GAD-7: 15
**Student Assignment Requirements**
**1. Pathophysiology (25%)**
· Neurobiology of depression and anxiety
· Substance use impact on CNS
· Pain–mood interaction
**2. Mental Health Assessment (35%)**
· Diagnostic differentiation
· Suicide risk screening
· Substance use screening
· Safety planning
**3. Pharmacology & Integrated Treatment (30%)**
· Antidepressant selection and titration
· Avoidance of high-risk medications
· Non-pharmacologic and referral planning
**4. APA & Evidence Use (10%)**
**RUBRIC – CASE STUDY 4 – Mental Health, Substance Use & Chronic Pain (100 Points)**
**1. Neurobiologic Pathophysiology (25 points)**
| | |
| — | — |
| **Level** | **Description** |
| **Excellent (23–25)** | Integrates neurobiology of mood disorders, substance use, and pain with strong application to clinical symptoms. |
| **Satisfactory (18–22)** | Accurate explanation with limited integration. |
| **Unsatisfactory (13–17)** | Partial or unclear explanation. |
| **Poor (1–12)** | Incorrect or superficial discussion. |
| **Not Submitted (0)** | Section not submitted or missing. |
**2. Mental Health & Safety Assessment (35 points)**
| | |
| — | — |
| **Level** | **Description** |
| **Excellent (33–35)** | Comprehensive assessment including diagnostic differentiation, suicide risk, substance use screening, and safety planning. |
| **Satisfactory (26–32)** | Assessment is appropriate but lacks depth or clarity in prioritization. |
| **Unsatisfactory (18–25)** | Incomplete assessment or missed safety considerations. |
| **Poor (1–17)** | Unsafe or inadequate evaluation. |
| **Not Submitted (0)** | Section not submitted or missing. |
**3. Pharmacology & Integrated Care Plan (30 points)**
| | |
| — | — |
| **Level** | **Description** |
| **Excellent (28–30)** | Evidence-based medication selection with safe prescribing, clear rationale, and integrated non-pharmacologic strategies. |
| **Satisfactory (22–27)** | Appropriate plan but lacks optimization or monitoring detail. |
| **Unsatisfactory (16–21)** | Limited pharmacologic understanding or justification. |
| **Poor (1–15)** | Unsafe or inappropriate treatment decisions. |
| **Not Submitted (0)** | Section not submitted or missing. |
**## CASESTUDY4.docx**
CASE STUDY 4: Depression, Anxiety, Substance Use, and Chronic Pain
**CASE STUDY 4 – Depression, Anxiety, Substance Use, and Chronic Pain**
**Case Scenario**
Ms. R.D. is a
**45-year-old female** presenting with insomnia, fatigue, chronic low back pain, and mood changes.
**History**
· PMH: Chronic pain, prior opioid exposure
· Reports alcohol use nightly
· PHQ-9: 17, GAD-7: 15
**Student Assignment Requirements**
**1. Pathophysiology (25%)**
· Neurobiology of depression and anxiety
· Substance use impact on CNS
· Pain–mood interaction
**2. Mental Health Assessment (35%)**
· Diagnostic differentiation
· Suicide risk screening
· Substance use screening
· Safety planning
**3. Pharmacology & Integrated Treatment (30%)**
· Antidepressant selection and titration
· Avoidance of high-risk medications
· Non-pharmacologic and referral planning
**4. APA & Evidence Use (10%)**
**RUBRIC – CASE STUDY 4 – Mental Health, Substance Use & Chronic Pain (100 Points)**
**1. Neurobiologic Pathophysiology (25 points)**
| | |
| — | — |
| **Level** | **Description** |
| **Excellent (23–25)** | Integrates neurobiology of mood disorders, substance use, and pain with strong application to clinical symptoms. |
| **Satisfactory (18–22)** | Accurate explanation with limited integration. |
| **Unsatisfactory (13–17)** | Partial or unclear explanation. |
| **Poor (1–12)** | Incorrect or superficial discussion. |
| **Not Submitted (0)** | Section not submitted or missing. |
**2. Mental Health & Safety Assessment (35 points)**
| | |
| — | — |
| **Level** | **Description** |
| **Excellent (33–35)** | Comprehensive assessment including diagnostic differentiation, suicide risk, substance use screening, and safety planning. |
| **Satisfactory (26–32)** | Assessment is appropriate but lacks depth or clarity in prioritization. |
| **Unsatisfactory (18–25)** | Incomplete assessment or missed safety considerations. |
| **Poor (1–17)** | Unsafe or inadequate evaluation. |
| **Not Submitted (0)** | Section not submitted or missing. |
**3. Pharmacology & Integrated Care Plan (30 points)**
| | |
| — | — |
| **Level** | **Description** |
| **Excellent (28–30)** | Evidence-based medication selection with safe prescribing, clear rationale, and integrated non-pharmacologic strategies. |
| **Satisfactory (22–27)** | Appropriate plan but lacks optimization or monitoring detail. |
| **Unsatisfactory (16–21)** | Limited pharmacologic understanding or justification. |
| **Poor (1–15)** | Unsafe or inappropriate treatment decisions. |
| **Not Submitted (0)** | Section not submitted or missing. |
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