All Sample Questions

Depression 5

Question

Vignette: A 23-year-old man comes to the clinic with complaints of feeling consistently sad, having decreased interest in activities he used to enjoy, significant weight loss, and insomnia for the past 2 weeks. His roommate mentions that he often finds him staring blankly at the ceiling at night. He also noticed that he has been speaking very slowly and has been having difficulty concentrating on his studies. The patient admits that he often thinks about death and feels life is not worth living. He denies any use of drugs or alcohol. He is currently in his first year of law school and states that the pressure to perform is very high. He has no significant past medical history. His vitals are within normal limits. His physical examination is unremarkable.

Question: Which of the following is the most likely diagnosis?

Choices

A. Major depressive disorder

B. Dysthymia

C. Adjustment disorder

D. Bipolar disorder

E. Seasonal affective disorder

Answer

A. Major depressive disorder

Explanation

The patient's symptoms such as a persistent feeling of sadness, loss of interest or pleasure in activities, significant weight loss, insomnia, psychomotor retardation, fatigue or loss of energy, feelings of worthlessness, diminished ability to think or concentrate, and recurrent thoughts of death which have been present nearly every day for at least 2 weeks are suggestive of Major Depressive Disorder. The DSM-5 criteria for MDD requires at least 5 of these symptoms to be present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure. The patient’s symptoms meet these criteria. Furthermore, his symptoms are causing significant distress and are not attributable to the physiological effects of a substance or another medical condition, which further supports the diagnosis.