a 47 y/o woman comes to the doctor because of difficulty sleeping for 2 months. during this period, she has been awakening at 3 AM and remain awake worrying about work, even though she is tired. she has stable angina and required stent placement 6 months ago and a second one 4 months ago. her chest pain started to recur 1 month ago and now she has it almost daily. evaluation shows no organic cause of her recurent pain. she works as an attorney for a large firm and reports that she has been giving more responsabilities during the last year. for the past year, she has not enjoyed her work as previously. she forces herself to go to work and has difficulty paying attention while she is there. she is a gourmet cook but no longer prepares food because she does not enjoy the taste of it. physical exam shows no abnormalities. on mental status exam, she has a sad and worried mood and a reactive affect. she is allert and orriented to person, time and place. she states that she frequently becomes despondent especially when she thinks about her heart disease. which is the most likely diagnosis:
a. adjustment disorder
b. dysthymic disorder
c. generalized anxiety disorder
d. major depressive disorder
e. primary insomnia
I choose A, the feeding back show it is wrone.
Now, I agree that a is wrong. But what is the answer? thank you all!
a. adjustment disorder
b. dysthymic disorder
c. generalized anxiety disorder
d. major depressive disorder
e. primary insomnia
I choose A, the feeding back show it is wrone.
Now, I agree that a is wrong. But what is the answer? thank you all!
