Chapter·PsychiatryDepression

Depression with atypical featuresDownloads

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1

A 65-year-old male who is being treated for depression visits your emergency room complaining of being unable to urinate. In addition, the patient complains of tachycardia and dry mouth. He has no history of benign prostatic hyperplasia and reports of only being on one psychiatric medication. What type of psychiatric medication would cause such a side effect profile?

ATricyclic antidepressant

BSerotonin norepinephrine reuptake inhibitor

CMonoamine oxidase inhibitor

DSelective serotonin reuptake inhibitor

EAminoketone

2

A 28-year-old woman presents with depressed mood lasting for most days of the week for the past month. She also mentions that she has lost her appetite for the past 3 weeks. She adds that her job performance has significantly deteriorated because of these symptoms, and she feels like she will have to quit her job soon. Upon asking about her hobbies, she says that she used to enjoy dancing and music but does not have any desire to do them anymore. The patient’s husband says that she has had many sleepless nights last month. The patient denies any history of smoking, alcohol intake, or use of illicit substances. No significant past medical history. Physical examination is unremarkable. Routine laboratory tests are all within normal limits. Which of the following clinical features must be present, in addition to this patient’s current symptoms, to confirm the diagnosis of a major depressive episode?

AIntense fear of losing control

BLack of concentration

CWeight loss

DAnterograde amnesia

ENightmares

3

A 25-year-old woman comes to the physician because of sadness that started 3 weeks after her daughter was born. Her daughter is now 9 months old and usually sleeps through the night, but the patient still has difficulty staying asleep. She has not returned to work since the birth. She is easily distracted from normal daily tasks. She used to enjoy cooking, but only orders delivery or take-out now. She says that she always feels too exhausted to do so and does not feel hungry much anyway. The pregnancy of the patient's child was complicated by gestational diabetes. The child was born at 36-weeks' gestation and has had no medical issues. The patient has no contact with the child's father. She is not sexually active. She does not smoke, drink alcohol, or use illicit drugs. She is 157 cm (5 ft 1 in) tall and weighs 47 kg (105 lb); BMI is 20 kg/m2. Vital signs are within normal limits. She is alert and cooperative but makes little eye contact. Physical examination shows no abnormalities. Which of the following is the most likely diagnosis?

AAdjustment disorder

BMajor depressive disorder

CNormal behavior

DDisruptive mood dysregulation disorder

EDepression with peripartum-onset

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