A 68 years old lady thinks that she has done a sin, she is not worth to live this world, she is also having anorexia and insomnia, she is suffering from –
**Core Concept**
A 68-year-old lady presenting with feelings of guilt, worthlessness, anorexia, and insomnia is likely suffering from a major depressive disorder, specifically a depressive episode with psychotic features. This condition involves a combination of depressive symptoms, including persistent sadness, loss of interest in activities, and changes in appetite or sleep, along with cognitive distortions and a sense of guilt.
**Why the Correct Answer is Right**
The correct diagnosis is supported by the presence of depressive symptoms, such as anorexia and insomnia, which are common in major depressive disorder. The patient's feelings of guilt and worthlessness are indicative of a depressive mood, and the presence of psychotic features, such as a distorted sense of reality, further supports this diagnosis. In older adults, major depressive disorder often presents with somatic symptoms, such as changes in appetite or sleep, which are evident in this patient.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not account for the depressive symptoms and cognitive distortions present in this patient. While anxiety disorders can involve somatic symptoms, they typically do not involve the same level of cognitive distortion as seen in this patient.
**Option B:** This option is incorrect because it does not take into account the patient's feelings of guilt and worthlessness, which are characteristic of major depressive disorder. While somatic symptom disorder can involve changes in appetite or sleep, it typically does not involve the same level of cognitive distortion as seen in this patient.
**Option C:** This option is incorrect because it does not account for the depressive symptoms and cognitive distortions present in this patient. While obsessive-compulsive disorder can involve feelings of guilt and worthlessness, it typically does not involve the same level of somatic symptoms as seen in this patient.
**Option D:** This option is incorrect because it does not take into account the patient's feelings of guilt and worthlessness, which are characteristic of major depressive disorder. While post-traumatic stress disorder can involve feelings of guilt and worthlessness, it typically does not involve the same level of somatic symptoms as seen in this patient.
**Clinical Pearl / High-Yield Fact**
In older adults, major depressive disorder often presents with somatic symptoms, such as changes in appetite or sleep, which can be mistaken for other conditions, such as anxiety disorders or somatic symptom disorder. It is essential to consider these symptoms in the context of the patient's overall presentation and cognitive function.
**Correct Answer: C. Major Depressive Disorder**