Vignette: A 21-year-old college student is brought to the hospital after being found unconscious in her dorm room. Her roommate reports that in the past few days, she has been acting highly energetic, overly talkative, and has not been sleeping. She has also been making impulsive decisions, such as spending a large amount of money on unnecessary items. The patient's medical history is unremarkable. She has no history of drug or alcohol abuse. Her mother mentions that the patient's father has been treated for a psychiatric disorder but is unsure of the specifics. Physical examination reveals normal findings. Which of the following is the most likely diagnosis?
B. Major depressive disorder
C. Manic episode
E. Generalized anxiety disorder
C. Manic episode
The patient's symptoms of increased energy, decreased need for sleep, pressured speech, and impulsive behavior strongly suggest a manic episode. These symptoms must last for at least one week (or any duration if hospitalization is necessary), according to the DSM-5 criteria for a manic episode. The patient's family history suggests a potential genetic predisposition to bipolar disorder, as first-degree relatives of individuals with bipolar disorder have a higher risk of developing the condition. Hypomania (Choice A) is similar to a manic episode but is less severe and does not cause marked impairment in social or occupational functioning or necessitate hospitalization. major depressive disorder (Choice B) is characterized by at least two weeks of depressed mood or loss of interest or pleasure in nearly all activities. The patient does not have any symptoms of depression. Schizophrenia (Choice D) typically presents with hallucinations, delusions, disorganized speech, disorganized or catatonic behavior, and negative symptoms. Generalized anxiety disorder (Choice E) is characterized by excessive anxiety or worry about various aspects of life, such as work, social interactions, or everyday routine events and activities, occurring more days than not for at least six months. The patient's presentation does not fit these criteria.