Depression, Anxiety, Substance Use, and Chronic Pain

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)