An adolescent diagnosed with disruptive mood dysregulation disorder (DMDD) is also found to be experimenting with alcohol and cigarettes. Which of the following interventions should the nurse prioritize to prevent the escalation of substance abuse?

A. Starting the adolescent on a course of antidepressants is inappropriate as a primary intervention for preventing substance use. While medication may be indicated for mood symptoms associated with DMDD, it does not directly address risky behaviors like alcohol and cigarette experimentation.

B. Providing education on the risks associated with substance use and offering supportive counseling is correct. substance use prevention in adolescents emphasizes early intervention through education, skill-building, and supportive guidance. Adolescents with DMDD may engage in risky behaviors due to impulsivity and mood dysregulation. Educating them about health risks, combined with counseling that fosters coping strategies, enhances awareness, self-control, and informed decision-making, reducing the likelihood of escalation to substance abuse.

C. Implementing strict disciplinary measures may create resistance, secrecy, or rebellion, and does not address the underlying emotional or behavioral drivers of substance use. Punitive approaches alone are not effective preventive interventions.

D. Encouraging isolation to avoid peer pressure is counterproductive. Social isolation can exacerbate mood dysregulation, anxiety, and depressive symptoms in adolescents. Supportive, structured social engagement is preferable to promote healthy peer interactions.

A. Postpartum psychosis is correct. postpartum psychosis is a rare but serious psychiatric emergency that typically occurs within the first 2 weeks after delivery. It is characterized by hallucinations, delusions, confusion, rapid mood swings, and disorganized behavior. The client’s report of vivid hallucinations and delusional thinking 10 days postpartum fits this clinical picture. Immediate intervention is critical due to the risk of harm to the mother or infant.

B. PMAD (perinatal mood and anxiety disorder) is a broad category that includes depression and anxiety disorders occurring during pregnancy or postpartum. While postpartum psychosis is included under severe PMADs, the term PMAD is not specific enough to describe the acute psychotic symptoms reported.

C. Postpartum depression involves persistent sadness, guilt, anxiety, or loss of interest, often accompanied by sleep and appetite disturbances. It does not typically include hallucinations or delusions, so this option does not match the client’s symptoms.

D. Postpartum blues (baby blues) usually begin within the first few days after delivery and resolve within 10–14 days. Symptoms are mild, transient, and include tearfulness, irritability, and mood swings. The presence of psychotic symptoms makes postpartum blues an inappropriate diagnosis in this scenario.