What are key considerations for a 23-year-old patient?

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From the Research

When caring for a 23-year-old patient, focus on both physical and mental health concerns common in young adults, prioritizing substance use screening, mental health assessment, sexual health counseling, and lifestyle factor encouragement, as these significantly impact morbidity, mortality, and quality of life. The importance of a thorough history and physical examination in diagnosis is supported by recent studies, such as 1, which highlights the cost-effectiveness and patient protection of using patient history and physical as a basis for selecting relevant diagnostic testing.

Key considerations for this age group include:

  • Screening for substance use (alcohol, tobacco, marijuana, and other drugs), as this age group has high rates of experimentation and potential for developing dependencies
  • Assessing mental health thoroughly, as anxiety, depression, and eating disorders often emerge or worsen during early adulthood, with studies such as 2 showing an association between mitochondrial DNA copy number and symptoms of depression, anxiety, and stress- and adjustment disorders
  • Providing sexual health counseling, including STI prevention, contraception options (such as combined oral contraceptives, IUDs, or implants), and HPV vaccination if not previously completed
  • Addressing lifestyle factors by encouraging regular physical activity (150 minutes of moderate exercise weekly), balanced nutrition, adequate sleep (7-9 hours nightly), and stress management techniques
  • Considering social determinants of health, including education, employment, housing stability, and insurance status, as these significantly impact health outcomes, as noted in studies such as 3, which emphasizes the importance of the physical examination in the outpatient setting for establishing a diagnosis and building the physician-patient relationship.

Young adults may have inconsistent healthcare utilization, so establishing rapport and emphasizing preventive care is crucial. Verifying immunization status, particularly for Tdap, meningococcal, and annual influenza vaccines, and obtaining comprehensive medical records for continuity of care are also essential considerations.

References

Research

Association of mitochondrial DNA in peripheral blood with depression, anxiety and stress- and adjustment disorders in primary health care patients.

European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 2017

Research

The Outpatient Physical Examination.

The Medical clinics of North America, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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