NE
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14 y/o girl presents with trouble concentrating at school just three months after witnessing her best friend being shot to death by another classmate. Ever since that "awful day" she has been very "sad" and withdrawn, often sitting on her bed, staring at the wall "for hours." She has frequent crying spells and refuses to play with friends or participate in her normal after-school activities. Her appetite has "dwindled down to nothing" and she feels very guilty that she survived the shooting. On further questioning, she reluctantly admits that she has constant thoughts of "joining her friend." She did not receive any counseling after the incident.
*** What’s the most likely Dx?
A. adjustment disorder
B. brief psychotic disorder
C. dysthymic disorder
D. major depressive disorder
E. normal grief
F. PTSD
*** What’s the most important q to ask at this time?
A. "Are you hearing voices?"
B. "Do you have any friends that you feel comfortable talking to at school?"
C. "Do you wear a helmet when you ride your bicycle?"
D. "Can you describe your typical weekly alcohol intake?"
E. "Have you thought of the means by which you can 'join your friend'?"
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| robin082006
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What’s the most likely Dx?
D major depressive disorder
What’s the most important q to ask at this time?
E. "Have you thought of the means by which you can 'join your friend'?"
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| mjl1717
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these are always tough and somewhat ambiguous...!!!
#1)I go answer d- depression.
#2) I go with answer e medicallegally ruling out suicide..
(although I must confess my gut feeling was adjustment disorder)
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| snowdrops
Forum Senior
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Because of suicide idea, it makes her close to depression rather than normal grief or adjustment disorder.
So, the answer is D.
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| rongg
Forum Newbie
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Dx for #1 is F, PTSD. Because major depression is ""feeling sad for no reason). Her psychological cosequences come after exposure the threatened death of her friend.
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| cookie909
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F
E
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| ts97
Forum Senior
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I remember we need to divide disorders to chtonic and acute first. I think in case of majpr depression - should be chronic, and we have acute here (3 months) + event. So my opinion is A (adjustment disorder). For second question - E.
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| coolmavs
Forum Elite
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I also go with PTSD and medically ruling out suicide
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| neo335
Forum Elite
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will go for Major depression as ha most of the criterias of "SIGECAPS" and as the patient if they have aby plans for the suicide ideations that the pt is having..
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