For a male client with dysthymic disorder, which of following approaches would nurse expect to implement?

Correct Answer: B. Psychotherapeutic approach

Dysthymia is a less severe, chronic depression diagnosed when a client has had a depressed mood for more days than not over a period of at least 2 years. Clients with dysthymic disorder benefit from psychotherapeutic approaches that assist the client in reversing the negative self-image, negative feelings about the future. In addition to pharmacotherapy, psychotherapy may be helpful. However, Dunner cautions that “treatment with psychotherapy is difficult.” A number of psychotherapies have been advocated including cognitive behavioral analysis system of psychotherapy (CBASP), interpersonal psychotherapy (IPT), cognitive behavioral therapy, manualized group therapy and problem-solving therapy, These do not exclude the potential value of supportive or psychodynamic psychotherapies.

• Option A: ECT is indicated in patients with treatment-resistant depression or severe major depression that impairs activities of daily living. The definition of treatment-resistant depression is depression that is unresponsive to multiple antidepressant medication trials. There are also suggestions for ECT as a treatment for suicidality, severe psychosis, food refusal secondary to depression, and catatonia. Bipolar depressive and manic patients can also receive treatment with ECT. ECT may have a safer profile than antidepressants or antipsychotics in debilitated, elderly, pregnant, and breastfeeding patients.
• Option C: Psychoanalysis is defined as a set of psychological theories and therapeutic techniques that have their origin in the work and theories of Sigmund Freud. The core of psychoanalysis is the belief that all people possess unconscious thoughts, feelings, desires, and memories. Psychoanalysis suggests that people can experience catharsis and gain insight into their current state of mind by bringing the content of the unconscious into conscious awareness. Through this process, a person can find relief from psychological distress.
• Option D: Antidepressants are a popular treatment choice for depression. Although antidepressants may not cure depression, they can reduce symptoms. The first antidepressant you try may work fine. But if it doesn’t relieve your symptoms or it causes side effects that bother you, you may need to try another.