A 53 year old female lawyer who has been married for 20 years comes to her physician’s office because she has not felt “up to par” over the past 2 months. She is married, has two grown sons, and has a good practice. In the past couple of weeks, she has stopped taking care of her appearance and has frequently called in sick to work, when she actually has been having difficulty getting out of bed. She states that she has lost her appetite recently and her interest in sex with her husband has decreased considerably. She recently told her husband that at times she wonders whether she should go on living. She denies any history of drug or alcohol abuse, and a complete physical examination 3 months earlier showed her to be in good health. Which of the following is the mostly likely diagnosis?
A 53 year old female lawyer who has been married for 20 years comes to her physician’s office because she has not felt “up to par” over the past 2 months. She is married, has two grown sons, and has a good practice. In the past couple of weeks, she has stopped taking care of her appearance and has frequently called in sick to work, when she actually has been having difficulty getting out of bed. She states that she has lost her appetite recently and her interest in sex with her husband has decreased considerably. She recently told her husband that at times she wonders whether she should go on living. She denies any history of drug or alcohol abuse, and a complete physical examination 3 months earlier showed her to be in good health. Which of the following is the mostly likely diagnosis?
💡 Explanation
**Core Concept:** Depression is a mental health disorder characterized by persistent feelings of sadness, hopelessness, and loss of interest in activities. It can affect various aspects of a person's life, including work, relationships, and personal care. In this question, we consider the clinical scenario involving a patient presenting with a range of symptoms, including changes in appearance, energy levels, appetite, and sexual function.
**Why the Correct Answer is Right:**
The correct answer, **C. Depression**, is the most likely diagnosis in this case due to the patient's reported symptoms, including loss of interest in sex, decreased energy level, loss of appetite, and thoughts of suicide. Depression is a common mental health condition that can be triggered by life events, such as marriage or job-related issues. In this case, the patient has been married for 20 years and has a good practice, suggesting that external factors are not the primary cause of her depression.
**Why Each Wrong Option is Incorrect:**
A. **Anxiety:** While anxiety can coexist with depression, the patient's symptoms do not align with the typical features of anxiety disorders, such as panic attacks or excessive worry.
B. **Alcohol or drug abuse:** The patient denies any history of drug or alcohol abuse, making this option less likely as a primary cause of her symptoms.
D. **Medication side effects:** A complete physical examination three months ago showed the patient to be in good health, making it less probable that medication side effects are the primary cause of her symptoms.
**Clinical Pearl:** It is essential to consider mental health conditions when evaluating patients presenting with a combination of symptoms affecting various aspects of their life. Depression is often underdiagnosed in patients presenting with vague symptoms, and a thorough understanding of mental health conditions is crucial for accurate diagnosis and appropriate management.
✓ Correct Answer: C. Major depressive disorder
📤 Share this MCQ
Share Card Preview
👆 1080x1080 square card — fills the full width in WhatsApp and Telegram