A 30 year old male was brought for evaluation. The history revealed that the patients 3 year old son died, 5 months back after being hit by a car. At the time of accident, patient was standing nearby and witnessed the accident. For last 5 months, he has been having symptoms of sadness of mood, crying spells, feelings of wohlessness, poor sleep and poor appetite. He has twice thought of killing himself but stopped at the end moment. He has not been attending the office of last 5 months. What is the likely diagnosis:
A 30 year old male was brought for evaluation. The history revealed that the patients 3 year old son died, 5 months back after being hit by a car. At the time of accident, patient was standing nearby and witnessed the accident. For last 5 months, he has been having symptoms of sadness of mood, crying spells, feelings of wohlessness, poor sleep and poor appetite. He has twice thought of killing himself but stopped at the end moment. He has not been attending the office of last 5 months. What is the likely diagnosis:
💡 Explanation
**Core Concept**
Major depression is a mood disorder characterized by prolonged and intense feelings of sadness, hopelessness, and loss of interest in activities. It often involves changes in appetite, sleep, and energy levels.
**Why the Correct Answer is Right**
The patient's symptoms, such as sadness of mood, crying spells, feelings of worthlessness, poor sleep, and poor appetite, are classic indicators of major depression. The presence of suicidal thoughts and the significant impact on his daily life, including not attending work for 5 months, further support this diagnosis. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for major depressive disorder include a persistent and intense depressed mood or loss of interest in activities, along with at least four other symptoms, such as changes in appetite or sleep, fatigue, feelings of worthlessness or guilt, difficulty concentrating, and recurrent thoughts of death.
**Why Each Wrong Option is Incorrect**
**Option A:** Post-traumatic stress disorder (PTSD) is a condition that develops after a person experiences a traumatic event, but it is characterized by symptoms such as flashbacks, nightmares, and avoidance of triggers, which are not mentioned in the patient's history.
**Option B:** Normal grief is a natural response to loss, but it is typically less intense and shorter-lived than the symptoms described in the patient's history. Grief also tends to focus on the loss itself, rather than the patient's overall mood and functioning.
**Option D:** Adjustment disorder is a condition that develops in response to a significant life change or stressor, but it is typically less severe and shorter-lived than major depression. The patient's symptoms have been persistent for 5 months, which is beyond the typical duration of an adjustment disorder.
**Clinical Pearl / High-Yield Fact**
It's essential to differentiate between normal grief and major depression, as the latter requires prompt treatment to prevent long-term consequences. A key distinguishing feature is the presence of significant impairment in daily life and the duration of symptoms.
✓ Correct Answer: C. Major depression
✓ Correct Answer: C. Major depression
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