Reference no: EM133686639

Question

A 64-year-old man with a history of major depressive disorder is admitted to the geriatric psychiatry inpatient unit after two months of worsening depression. His symptoms include depressed mood, social withdrawal, and a steady decline in self-care. The patient is a widower with a history of alcohol dependence and has been sober for the last 13 years. He has a history of seven psychiatric hospitalizations for depressive episodes dating back to his early 20s. His past medical history includes high cholesterol treated with atorvastatin. His psychiatric medications include sertraline 100 mg daily and lithium 300 mg daily. The patient saw his psychiatrist six weeks ago and stopped taking all his medications one week prior to admission. On exam, he has poor eye contact, significantly delayed response time, and psychomotor slowing. He also expresses a wish to die and see his wife again. Since admission, he has refused all treatment, including routine blood work, vitals, and medication. He has refused to eat for the last few days. The patient achieved remission from a depressive episode in his late 50s after receiving ECT. The inpatient psychiatric team is granted a court order for treatment over his objection, including blood work, medication administration,