Jamal is a 40 year-old African American male. He is brought to a local, out-pati
ID: 80910 • Letter: J
Question
Jamal is a 40 year-old African American male. He is brought to a local, out-patient mental health facility by his wife. She expresses concern about him, because he has been withdrawn for the last 2 or 3 weeks. She describes him as being irritable and restless. She also says he eats very little and has lost almost 10 pounds in the past 2 weeks. He agrees that he has been irritable; however, he attributes his irritability to the fact that he has been unable to sleep for the past few weeks. Jamal used to play basketball with his friends, but he reports that he no longer has the energy to play. He reports having symptoms of depression and frequent suicidal thoughts. He has been under a considerable amount of work stress. He is a fork-lift driver for a local manufacturing plant. When asked to elaborate about his work stress, he says, “They want to fire me. They say I’m not productive like I used to be. I just can’t get focused.” He feels as though he “blacks out” frequently when he is at work. Jamal worries a lot about losing his job, because he needs to provide for his family. Jamal reports that he used to have periods where he had a lot of energy and could complete multiple projects simultaneously. But, he now feels so lethargic that he often thinks of suicide. Jamal reports that he experiences occasional headaches. He also suffered from a ruptured disc 5 years ago.
Based on the information provided, which diagnosis would best fit Jamal’s symptoms?
A. F34.1 Persistent depressive disorder (dysthymia), provisional
B. F41.1 Generalized anxiety disorder, provisional
C. All of the above
D. F32.2 Major depressive disorder, single episode severe, provisional
E. F34.8 Disruptive mood dysregulation disorder, provisional
Explanation / Answer
Ans. persistent depressive disorder, provisional
reason- symptoms are :
- poor appetite
- sleep problem
- irritability
-poor concentration
-lethargic
Patient suffered from major health problem (disc rupture) 5yrs back.
It is provisional diagnosis because it need to be ruled out from bipolar or other disorder. As patient also stated that he was very active and multi tasking. So it might be case of mania and depression episode
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