NURS FPX 4015 Assessment 3 Concept Map: The 3Ps and Mental Health Care

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Capella university

NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care

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Date

Concept Map: The 3Ps and Mental Health Care

Major Depressive Disorder (MDD) remains one of the most significant mental health conditions globally, currently ranking as the third leading contributor to the global burden of disease (Bains & Abdijadid, 2023). Understanding the three fundamental factors that influence MDD—psychological, physiological, and pharmacological—collectively known as the 3Ps, is essential for creating comprehensive, evidence-based treatment plans. This framework assists in clinical reasoning and enhances the delivery of personalized, patient-centered care for individuals experiencing depression.

Case Scenario

Ivy Jackson is a 61-year-old woman presenting with symptoms characteristic of Major Depressive Disorder following the dissolution of her 38-year marriage. Her reported symptoms include persistent sadness, emotional distress, disrupted sleep, and noticeable weight loss, all of which align with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for MDD. To address her condition effectively, a thorough evaluation encompassing risk factors, diagnostic tests, medication management, potential complications, and nursing interventions is required.

Mental Health Diagnosis

Ivy’s clinical presentation is indicative of Major Depressive Disorder, featuring symptoms such as anhedonia, fatigue, impaired cognition, and insomnia (Bains & Abdijadid, 2023). The end of her long-term marriage has triggered persistent psychological symptoms, including hopelessness and emotional withdrawal. She has experienced an unintentional 10-pound weight loss attributed to reduced appetite, along with increased fatigue and difficulty concentrating. Although she denies suicidal thoughts, her emotional and social withdrawal heighten her risk, requiring vigilant assessment and support.

Several factors contribute to Ivy’s depressive episode. Her recent divorce, a family history of depression, and her current social isolation are major psychosocial contributors. Genetic predisposition also plays a role, given her mother and brother’s history of depression. Ivy’s medical background includes hypertension and previous episodes of depression, especially during emotionally taxing periods such as her youngest child leaving for college. She was formerly prescribed venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), but discontinued its use due to distressing withdrawal symptoms. Research indicates that poor adherence to antidepressant regimens is strongly associated with recurrence of depressive symptoms (Naudín et al., 2022).

While her depressive symptoms were initially triggered by her divorce, her condition exceeds the scope of situational depression, which generally resolves once the precipitating stressor subsides. MDD, on the other hand, is marked by persistent symptoms and involves underlying biological disturbances such as neurotransmitter imbalances and hypothalamic-pituitary-adrenal (HPA) axis dysfunction (Remes, 2021). Given the chronicity and severity of her condition, Ivy would benefit from a multi-pronged treatment plan that includes pharmacologic therapy, psychotherapy, and lifestyle changes to promote adherence and enhance her quality of life.

Concept Map for Ivy Jackson

Factors	Psychological	Physiological	Pharmacological
Risk Factors	Divorce, family history of depression, social isolation	Hypertension, past depressive episodes	Discontinuation of venlafaxine, medication non-adherence
Signs & Symptoms	Persistent sadness, hopelessness, crying, anhedonia	Fatigue, weight loss, sleep disruption, poor appetite	Antidepressant side effects, withdrawal symptoms
Diagnostics	DSM-5 criteria for MDD	Thyroid function tests, CBC, Vitamin D screening	History of medication response, adherence patterns
Complications	Chronic depression, social isolation, cognitive impairment	Poorly controlled hypertension, nutritional deficiencies	Relapse due to non-compliance, treatment resistance
Nursing Interventions	CBT, Interpersonal Therapy, enhancing social support	Sleep hygiene education, diet consultation, promote exercise	Educate on medication use, manage side effects, ensure compliance

Conclusion

Ivy Jackson’s case underscores the complex, multifactorial nature of Major Depressive Disorder. Utilizing a concept map based on the 3Ps—psychological, physiological, and pharmacological—provides a systematic framework for identifying risk factors, clinical manifestations, diagnostics, and therapeutic strategies. Effective management of MDD involves not only treating symptoms but also addressing underlying contributors and ensuring patient adherence. A holistic, patient-centered approach that integrates psychotherapy, medical treatment, and lifestyle interventions is vital to support Ivy’s recovery and long-term mental well-being.

References

Bains, N., & Abdijadid, S. (2023, April 10). Major depressive disorder. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559078/

Chand, S., & Arif, H. (2023). Depression. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430847/

Lieshout, R. J. V., Layton, H., Savoy, C. D., Haber, E., Feller, A., Biscaro, A., Bieling, P. J., & Ferro, M. A. (2022). Public health nurse-delivered group cognitive behavioural therapy for postpartum depression: A randomized controlled trial. The Canadian Journal of Psychiatry, 67(6), 432–440. https://doi.org/10.1177/07067437221074426