A 45 year old father presents with sleep deprivation, lethargy headache, and low mood two months after knowing that his son is suffering from leukemia. He interacts reasonably well with others, but has absented himself from work. Which of the following is the most probable diagnosis?
Correct Answer: Adjustment disorder
Description: The patient in question has an identifiable stress in the form of his son suffering from leukemia. After this identifiable stress this patient developed symptoms of lethargy, low moods, headache, sleep deprivation, and staed missing work. Since the symptoms appeared within 3 months of the onset of stressor, a diagnosis of adjustment disorder is most likely. DSM IV Diagnostic criteria for adjustment disorder includes: Development of emotional or behavioral symptoms in response to an identifiable stressor occurring within 3 months of onset of the stressor. These symptoms are clinically significant as evidenced by the following: Marked distress that is in excess of what would be expected from exposure to the stressor Significant impairment in social or occupational functioning Stress related disturbance does not meet the criteria for another specific Axis I disorder and is not merely an exacerbation of a pre existing Axis I or Axis II disorder The symptoms does not represent bereavement Once the stressor has terminated, the symptoms do not persist for more than additional 6months It is said to be acute when the disturbance last for less than 6months and chronic if disturbance last for more than 6 months. Ref: Psycho-Oncology By Jimmie C. Holland, 2nd Edition, Page 304; Lippincott's Primary Care Psychiatry By Robe M. McCarron
Category:
Psychiatry
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