DrVirgo
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A 47 year old man comes to the physician 1 year after his wife died in a car accident. Eversince the accident, he has had feelings of worthlesness, insomnia, self-blame, and fatigue. He does not go out with friends and has stopped going out to football games which was once his favorite passtime. He is "sad all the time", has lost 15 pounds, frequently spends nights and weekends crying on the couch, and finds it difficult to move. Sometimes he cannot even get up to go work. He says his symptoms have been worsening over time. He is not so sure he wants to "be around" without his wife anymore. Which of the following is the most likely diagnosis?
A. Conversion disorder
B. Dysthmic disorder
C. Major depressive disorder
D. Normal grief
E. Separation anxiety
PLEASE EXPLAIN your answer.
Thanks.
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| robin082006
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C
Based on symptoms and time.
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| babli
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Major depressive disorder
According to the DSM-IV-TR criteria for diagnosing a major depressive disorder one of the following two elements must be present:
* Depressed mood, or
* Loss of interest or pleasure.
It is sufficient to have either of these symptoms in conjunction with four of a list of other symptoms. These include
* Feelings of overwhelming sadness or fear or the seeming inability to feel emotion (emptiness).
* A decrease in the amount of pleasure derived from what were previously pleasurable activities.
* Inattention to personal hygiene.
* Changing appetite and marked weight gain or loss.
* Disturbed sleep patterns, such as insomnia, loss of REM sleep, or excessive sleep.
* Changes in activity levels, such as restlessness or a slowing of movement.
* Fatigue, mental or physical.
* Feelings of guilt, helplessness, hopelessness, anxiety, or fear.
* A decrease in self-esteem.
* Trouble concentrating or making decisions or a generalized slowing and obtunding of cognition.
* Self-harm or ruminating on self-harm.
* Ruminating on death or suicide.
* Reduced memory.
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| DrVirgo
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thanks. Thats what I thought as well.
Would it be normal grief if the same symptoms were present for UNDER a year?
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| robin082006
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Normally Major depressive disorder lasts more than months. If not, maybe other disorders
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