Depression that persisted through six sober weeks anchors this MN661 Unit 10 integrated case study, which diagnoses two conditions, chooses one combined therapy and plans for the risk drinking adds. Searches like "mn 661 unit 10 assignment example", "mn661 unit 10 sample" and "mn661 unit 10 example" land here.
Depression, Drinking and a Six-Week Sober Interval: An Integrated Case Study of a 39-Year-Old Sous-Chef
[Student Name]
Purdue University Global
MN661: PMHNP Psychopathological Disorders and Psychotherapy
Unit 10 Assignment
[Instructor Name]
[Date]
Composite patient written as a model document. Medication decisions are left to a referral, and every regimen, name and number is bracketed.
Case Summary
A composite 39-year-old sous-chef reports low mood most days for about eight months, poor sleep, loss of interest in cooking at home and in cycling, feelings of worthlessness and trouble concentrating on orders. He drinks six to eight beers most nights after his shift, starting around midnight. Last year, after an episode of acute pancreatitis, he stopped drinking completely for six weeks on his doctor's advice. He says his mood "was just as bad, maybe worse" during those weeks. He has passive thoughts of death late at night after shifts, usually after drinking, but no plan or intent. He is divorced and sees his 12-year-old daughter every other weekend.
Diagnosis
Major depressive disorder. He reports depressed mood, loss of interest, insomnia, worthlessness, poor concentration and passive thoughts of death, six of nine symptoms, for well over two weeks, with impairment at work. The criteria are met (American Psychiatric Association, 2022).
Alcohol use disorder. Of eleven criteria, he meets five: drinking more than intended, unsuccessful efforts to cut down, craving, continued use despite a physical problem made worse by alcohol (the pancreatitis) and tolerance. Five criteria place the disorder in the moderate range. His AUDIT score of 18 falls in the higher-risk range and supports the diagnosis (Babor et al., 2001).
The Sober Interval
The key question is whether the depression is caused by the drinking; a depressive disorder induced by alcohol usually improves substantially within about a month of abstinence, and his did not improve during six sober weeks. That interval argues against an alcohol-induced depressive disorder and in favor of an independent major depressive disorder that coexists with alcohol use disorder. The evidence has limits: it is a single episode, recalled rather than recorded, and he was recovering from pancreatitis at the time, which could itself have lowered his mood. Neither condition is allowed to explain the other until this interval has been examined, and the conclusion is held as a working one.
Other Possibilities Considered
Three alternatives were weighed. An alcohol-induced depressive disorder was the main rival and is argued against by the sober interval. Bipolar disorder was considered because depression is sometimes the first presentation; he reports no period of elevated mood, decreased need for sleep or unusual energy, and his sister, who sees him every week, confirms none. A medical cause was considered because pancreatitis and heavy drinking can be associated with thyroid and nutritional problems; recent thyroid tests and a vitamin B12 level were normal. Grief was considered because his father died two years ago, but his low mood began more than a year later and centers on worthlessness rather than on longing for his father.
Formulation Linking the Two
Building on the diagnosis, the formulation explains how the two conditions keep each other going. After long evening shifts, he comes home wound up and alone; drinking helps him unwind and fall asleep, but it disrupts sleep later in the night and deepens his low mood the next day. Low mood makes it harder to exercise or see friends, which leaves the evenings emptier and the drinking more likely. The passive thoughts of death arrive late at night, after drinking, when he is most isolated.
Treatment Choice
Because the drinking and low mood reinforce each other at the same time of day, an integrated approach is preferred over treating one and then the other. Integrated cognitive behavioral therapy with motivational interviewing addresses both together: motivational interviewing to strengthen his own reasons for changing his drinking, and cognitive behavioral work on the evening pattern, sleep, activity and the beliefs behind his worthlessness. A meta-analysis of trials treating coexisting alcohol use disorders and depression with these methods found small but meaningful benefits for both drinking and depressive symptoms (Riper et al., 2014). Sessions would be scheduled on his days off, since his shifts end late. The first sessions would focus on his own reasons for change, which he has already named: his pancreatitis, his worry about his daughter seeing him drink, and his loss of interest in cooking. Later sessions would replace the midnight drinking with a wind-down routine, restore activities he used to enjoy and challenge the belief that he is "useless outside the kitchen."
Safety
Building on the formulation, the safety plan uses the Stanley-Brown structure (Stanley & Brown, 2012). Drinking alone after a shift is listed as a warning sign, because it is the factor that turns passive thoughts into higher risk. His coping strategies include a late-night call arrangement with [his sister], and professional contacts include [his clinician] and the 988 Suicide and Crisis Lifeline. He has no firearm at home and agreed to keep only a small supply of any sleep aid. The plan itself is kept with his record and is not reproduced here.
Work and the Kitchen
His workplace matters to both conditions. Restaurant kitchens often end late and have a culture of drinking together after service, and his crew goes out most nights. He says the drink after work is "what everyone does," and he worries that stopping will cost him his place in the group. Treatment will need to address that directly, for example by planning what he will order when he joins the crew or by finding other ways to unwind that fit his schedule, such as the early-morning rides he used to take. He also fears his head chef learning about treatment, so appointments and any work notes will be handled with his consent only.
Measuring Progress
Progress will be measured with the PHQ-9 at each session for depression, a weekly calendar of drinking days and drinks per day, and the AUDIT repeated at three months. His own goal, stated in the first session, is to "wake up without dreading the day," and he will rate how often that happens each week, which gives a measure in his terms alongside the standard ones.
Referral and Open Questions
A referral is made to [a psychiatric nurse practitioner colleague] for review of medication for depression and for alcohol use disorder, with any regimen decided there. Open questions: whether a second, recorded period of abstinence would confirm the independent depression; whether his pancreatitis history affects medication choices; and how his work schedule, which changes every week, can accommodate regular treatment sessions.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Publishing.
Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for use in primary care (2nd ed.). World Health Organization.
Riper, H., Andersson, G., Hunter, S. B., de Wit, J., Berking, M., & Cuijpers, P. (2014). Treatment of comorbid alcohol use disorders and depression with cognitive-behavioural therapy and motivational interviewing: A meta-analysis. Addiction, 109(3), 394-406. https://doi.org/10.1111/add.12441
Stanley, B., & Brown, G. K. (2012). Safety planning intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256-264. https://doi.org/10.1016/j.cbpra.2011.01.001
How this MN661 Unit 10 example is structured
No section starts cold; the first sentence of each points back to what came before, so the document reads as one argument rather than three assignments stapled together. The diagnosis is built first and conservatively, with each condition's criteria counted separately; the paper does not let the alcohol explain the depression, or the reverse, until the sober interval has been examined. That interval is presented with its limits, a single episode, recalled rather than recorded. The therapy choice follows from a formulation in which drinking and low mood reinforce each other at night, which is why a combined approach is preferred over sequential treatment. The safety section is short, pointing to the plan's structure without reproducing it, and names alcohol as the factor that turns passive thoughts into higher risk. Medication appears only as a referral, and every regimen, name and number stays bracketed.
Get an MN661 Unit 10 example written to your instructions
Bring together what earlier MN661 units produced if you have it, plus the Unit 10 case, prompt and rubric. The integrated study costs nothing the first time and is returned within 24-48h; it counts criteria for each condition separately, argues one therapy from the formulation, and connects its safety section to the diagnosis rather than attaching it. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
MN661 Unit 10 questions, answered
Can earlier unit work be reused in the integrated case?
Your own earlier work, yes, when the case carries over and the instructions permit reuse; many final units are designed to build on it. Revise rather than paste, since the integrated version needs connecting sentences and may need corrections your instructor suggested. A sample prepared for you is written fresh to the case supplied, not assembled from other documents.
How is a substance-induced disorder told apart from an independent one?
Mainly by timing. Symptoms that began before heavy use, or that persist for a substantial period, typically around a month, after use stops, point toward an independent disorder. Symptoms that appear only during use or withdrawal and resolve with abstinence point toward an induced one. The paper should state which evidence the case offers and how reliable it is.
Should the case study recommend medication?
Only a referral, unless the prompt explicitly asks for pharmacological reasoning. This course centers on diagnosis and psychotherapy, and a medication question is best kept brief and apart from the therapy argument. Where the prompt does request it, that reasoning belongs in its own section, with regimens held in brackets and no dosing presented as advice.