asmi
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A 25-year-old moderately obese woman with a history of bipolar disorder diagnosed at age 19 complains to her physician that her recent struggles with her weight and eating have caused her to feel depressed. She states that she has recently had increased difficulty sleeping, has felt excessively anxious and agitated, and has had increasing thoughts of suicide. She often finds herself fidgety and unable to sit still for extended periods of time. Her family tells her that she is increasingly irritable. She has never previously attempted suicide. Her current medications include lithium carbonate and zolpidem as needed for sleep. Which of the following is more consistent with a diagnosis of major depressive disorder than bipolar depression in this patient during this episode?
A. Early onset of bipolar disorder
B. Increased appetite
C. Insomnia
D. Increased thoughts of suicide
E. Psychomotor agitation
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| tess
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D. Increased thoughts of suicide
However, I still think even in this situation, the diagnosis is still "bipolar disorder". what do you think? 8)
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| asmi
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I also went wrong first by selecting D
since past history is of bipolar disorder , we may confuse with inc risk of suicide,which is common in bipolar depression .But here since they have given clear cut criteria for major depressive disorder , i would say its E.
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| sudipto1973
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suicidal ideation is always a very strong indicator of major depression whereas psychomotor agitation can be seen in both major depression as well as bipolar depression. The answer seems to me as pretty much D.
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| docdoc
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I came across this question somewhere, probably in NMS. I also marked it D and it was wrong, HOWEVER I still beleive D is the right answer.
I think psychomotor agitation can occur in both BPD and MD.
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| asmi
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this was kaplan Q and answer given was E.
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| BellKicker
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Am I missing something here or is this q totally weird. Obvisously, any symptom of major derpression fits under bipolar, also.....
The only explanation I can think of why E might be right would be that she was previsouly misdiagnosed as a bipolar because she has signs of atypical depression (agitation etc.).
Thoughts?
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| docdoc
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Is it in qbook or qbank? Can you give their explanation, thanks
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| nonstopdoc1
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qbank and answer is E
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| nonstopdoc1
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1.A 25-year-old moderately obese woman with a history of bipolar disorder diagnosed at age 19 complains to her physician that her recent struggles with her weight and eating have caused her to feel depressed. She states that she has recently had increased difficulty sleeping, has felt excessively anxious and agitated, and has had increasing thoughts of suicide. She often finds herself fidgety and unable to sit still for extended periods of time. Her family tells her that she is increasingly irritable. She has never previously attempted suicide. Her current medications include lithium carbonate and zolpidem as needed for sleep. Which of the following is more consistent with a diagnosis of major depressive disorder than bipolar depression in this patient during this episode?
a)Early onset of bipolar disorder
b)Increased appetite
c)Insomnia
d)Increased thoughts of suicide
e)Psychomotor agitation
this is the question and here is the explanation
Major depressive disorder is a syndrome that requires a depressed mood or loss of interest or pleasure and causes clinically significant distress or impairment in occupational, social, or other important areas of functioning. The diagnosis of bipolar depression requires that the patient have also had a manic episode of bipolar disorder. Bipolar depression is associated with less psychomotor agitation compared to unipolar depression (major depressive disorder), and thus the patient's agitation is more consistent with a major depressive disorder diagnosis than with the depression of bipolar disorder. Early onset of bipolar disorder (choice A) is a risk factor for the development of bipolar, rather than unipolar depression in later life. Increased appetite (choice B) is more a symptom of the depression of bipolar disorder than major depressive disorder, as one of the criteria for major depressive disorder is loss of appetite or anorexia. Insomnia (choice C) is found more often in bipolar depression than major depressive disorder. Increased thoughts of suicide (choice D) is incorrect because bipolar depression carries a greater risk of suicide than major depressive disorder.
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