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

Student Name

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 a significant public health concern and is currently the third leading contributor to the global burden of disease (Bains & Abdijadid, 2023). A comprehensive understanding of its development and progression involves exploring three key components: psychological, physiological, and pharmacological influences—collectively referred to as the “3Ps.” These factors form a foundational framework for clinical assessment and care planning, facilitating a more holistic and evidence-based approach to mental health treatment. Employing a concept map enables mental health professionals to systematize these elements, enhancing diagnostic accuracy and the delivery of patient-centered interventions.

Case Scenario

Ivy Jackson, a 61-year-old woman, presents with clinical signs consistent with Major Depressive Disorder. Her current depressive episode appears to have been initiated by the dissolution of her 38-year marriage, a profound life stressor. Ivy exhibits persistent sadness, loss of appetite, sleep disturbances, chronic fatigue, and cognitive slowing. According to DSM-5 diagnostic criteria, her symptoms support an MDD diagnosis. Ivy also reports emotional numbing and social withdrawal, although she currently denies suicidal ideation. Given these symptoms, a multidimensional evaluation and individualized care plan are necessary.

Several underlying and interacting factors contribute to Ivy’s mental health decline. Psychosocially, she is dealing with the aftermath of a major relational loss, compounded by a family history of depression. Physiologically, her medical history includes hypertension and previous depressive episodes linked to life transitions, such as her youngest child leaving for college. Genetically, both her mother and brother have experienced depression, increasing her vulnerability. Pharmacologically, Ivy had previously been prescribed venlafaxine, an SNRI, but discontinued its use due to uncomfortable withdrawal symptoms. Discontinuation and poor adherence to medication are well-documented contributors to relapse in MDD (Naudín et al., 2022).

Although Ivy’s symptoms originated in response to a situational stressor, the persistence and intensity of her symptoms are more indicative of MDD than situational depression. Unlike situational depression, which typically resolves with time and coping, MDD involves neurobiological dysregulation, such as neurotransmitter imbalance and dysfunction of the Hypothalamic-Pituitary-Adrenal (HPA) axis (Remes, 2021). Her chronic symptoms, family predisposition, and treatment non-adherence point to the necessity of a comprehensive and integrative management plan involving psychotherapy, pharmacotherapy, and lifestyle interventions.

Concept Map for Ivy Jackson

The following table outlines the psychological, physiological, and pharmacological dimensions of Ivy Jackson’s MDD, offering a structured overview for clinical evaluation and intervention:

Factors	Psychological	Physiological	Pharmacological
Risk Factors	Divorce, social isolation, family history of depression	Hypertension, prior depressive episodes	Discontinuation of venlafaxine, past medication non-adherence
Signs & Symptoms	Hopelessness, persistent crying, emotional withdrawal, anhedonia	Insomnia, fatigue, appetite loss, weight loss	Withdrawal symptoms, sensitivity to side effects
Diagnostics	DSM-5-based mental health assessment, mood evaluations	Blood tests (e.g., CBC, thyroid), vitamin D deficiency screening	Medication adherence history, treatment response tracking
Complications	Cognitive impairment, chronic emotional distress, social dysfunction	Nutritional imbalance, poor hypertension control	Increased relapse risk, ineffective symptom control
Nursing Interventions	Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT), building social networks	Encourage physical activity, promote sleep hygiene, nutrition guidance	Educate on medication adherence, manage side effects, support follow-up care

Conclusion

Ivy Jackson’s case exemplifies the importance of addressing MDD through a multifaceted framework that incorporates psychological, physiological, and pharmacological domains. Using a structured concept map allows clinicians to visualize and analyze contributing factors, symptom presentation, and targeted interventions. Ivy’s treatment must be both evidence-based and personalized, emphasizing ongoing assessment, consistent medication management, therapeutic support, and lifestyle adjustments. A holistic, patient-centered model of care is crucial for improving Ivy’s treatment outcomes and supporting her long-term recovery and 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

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

Naudín, M. A.-P., Abejón, E.-G., Gómez, F.-H., Lázaro, D.-F., & Álvarez, F. J. (2022). Non-adherence to antidepressant treatment and related factors in a region of Spain: A population-based registry study. Pharmaceutics, 14(12), 2696. https://doi.org/10.3390/pharmaceutics14122696

Remes, O. (2021). Biological, psychological, and social determinants of depression: A review of recent literature. Brain Sciences, 11(12), 1–33. https://doi.org/10.3390/brainsci1112163