health condition of having psoriasis could stop her to be socially engage

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health condition of having psoriasis could stop her to be socially engage, to go for swimming or work. For example, in front of people, she will feel embarrassed to show her body or her skin condition. Therefore, this could lead to social exclusion and isolation. (Selten et al., 2017). Selten et al., (2017), suggest that social exclusion has an impact on human dopaminergic functioning and thereby influences the risk of developing psychosis. Therefore, Danielle’s social activities help her to socialise with others, avoid stress, depression and reduce bipolar’s symptoms. Bipolar mood disorder is a complex mental illness characterized by uncertainties of mood between the highs of obsession and the lows of depression with periods of relatively normal mood in between (McKenna & Eyler, 2012). Alterations of brain structure and function combined with environmental factors (stressors, sleep deprivation or sleep much, weight gain or loss….) are thought to cause a dysregulation of mood, sleep, cognition, endocrine function, and motor systems forming complex and dynamic interactions (Catapano, et al., 2009). Other symptoms can be, hallucinations, inability to communicate due to markedly speeded up, slowed down or distorted speech. Bipolar disorder affects more than 1% of the world’s population irrespective of nationality, ethnic origin, or socioeconomic status and represents one of the leading causes of disability among young people (Grande et al., 2017). In a worldwide mental health survey, the prevalence of bipolar disorders was consistent across diverse cultures and ethnic groups, with an aggregate lifetime prevalence of 0·6% for bipolar I disorder, 0·4% for bipolar II disorder, 1·4% for subthreshold bipolar disorder, and 2·4% for the bipolar disorder spectrum. With respect to sex, bipolar I disorder affects men and women equally while bipolar II disorder is most common in women. (Grande et al., 2017). In addition, people with learning disabilities suffer from mood or bipolar disorders at a similar or even higher rate than general population (Morgan et al., 2008); such dually diagnosed people with learning disabilities are often more functionally impaired and require more health needs support than those without learning disabilities (Morgan et al., 2008). As hospitalizations are often required in managing acute episodes of bipolar disorders, with estimated prevalence rates at 1.04% for learning disability (Maulik et al., 2011) and 3 to 5.84% for bipolar disorders among the general population (Hoertel et al., 2013), a substantial number of individuals dually diagnosed with bipolar disorders and learning disabilities will be hospitalized because of acute bipolar episodes some time during their evolution. Additionally, there are several methods available to cure bipolar, such as mix of medication and psychotherapy. The main cure for an episode of mania or hypomania is typically antipsychotic medications while treatment for depression in people with bipolar could be only psychological therapy or combined with medication. Lithium is the most common and effective type of mood stabiliser used for treating bipolar disorder and anti-psychotic medication examples, Olanzapine and Quetiapine. (Conus et al., 2015).The student nurse will focus now on the nursing process (Assessment, Planning, Implementing and Evaluation). The nurse will use the pas-add tool to assess Danielle’s health need. The Pas-add Checklist is a questionnaire of 25 items, designed to be used primarily by careers and family members. These are the people who are the first to notice any change in the behaviour of those for whom they care, so as to decide on the need for an assessment in a clinical setting. (Allen et al., 2017). In addition, The Pas-add tool helps to have a precise understanding of the need for clinical assessment and define the presence of any disorder. They have the great advantage of allowing personnel with no training in psychiatry or psychology to detect a possible psychiatric disorder, greatly extending the scope for assessment of the people with disabilities, in different contexts and at all ages and degrees of disability. (Allen et al., 2017). Furthermore, Bipolar mood disorders carry substantial risks for patients and sometimes others. (Bassett, 2010). Therefore, it is important to ensure the risk assessment is done in order to minimise the hazard. For example, mania brings particular risks of disinhibition, poor judgement, risk taking and sometimes aggression. Depression brings notable risks of suicidal behaviour, poor self-care and homicide and Both mania and depression bring risks of substance misuse and disrupted relationships. Therefore, management requires an optimal therapeutic alliance with good communication, appropriate treatment and sometimes compulsory care during crises (Bassett, 2010).Danielle is 53 years old, she has mild learning disability, mental health, Bipolar mood Disorder and psoriasis. She has also sleep problem and eating disorder. She has been