Thursday, July 21, 2011


This is a practice question I did the other day.

A 19-year-old man is evaluated for depression of 6 weeks duration. He enrolled in college as a freshman 5 months ago and began participating in intramural basketball, football, and soccer in addition to carrying a full academic load and having a part-time job. He smokes cigarettes and marijuana and consumes more than 12 alcoholic drinks on the weekends at parties. He is sexually active with four different partners. However, during the last 6 weeks he has seldom left his room and has stopped attending classes because he cannot concentrate; he is in danger of failing all of his classes. He feels restless, cannot sleep, has a poor appetite, and feels depressed. He can identify no precipitating event related to his change in mood, although he had a similar episode once before at age 16 years. There is no family history of mood disorders.

Which of the following is the most likely diagnosis?

(a) Bipolar disorder
(b) Dysthymia
(c) Major depressive disorder
(d) Seasonal affective disorder
(e) Situational adjustment reaction with depressed mood

(Question from MKSAP for students 4, American College of Physicians)

The answer I gave: Major Depressive Disorder
The one they said was right: Bipolar Disorder

They thought his behavior when starting college was "hypomanic".
I would just label that at "college freshman". No??

Interesting how much depends on your perspective.

So I've been studying lately, and sweating, and packing up my car wearing a dress, and sweating through the dress, and planning stuff for this weekend.
Fun things to post about coming up ...
a 30th birthday, a wedding, time in Vermont, and Buckfest.
And that's just the next 4 days!

"A question that sometimes drives me hazy: am I or are the others crazy? "
-Albert Einstein

No comments:

Post a Comment