Reference no: EM133526532
1 What is this patient's most likely diagnosis?
a. Bipolar I Disorder
b. Generalized Anxiety Disorder (GAD)
c. Major Depressive Disorder
d. Obsessive-Compulsive Disorder
e. Personality disorder not otherwise specified
2 Which of the following would be the most appropriate initial treatment for this patient?
a. Referral to Narcotics Anonymous
b. Antidepressant Medication
c. Olanzapine (Zyprexa)
d. Electroconvulsive Therapy
Case Study:
A Tired Mom Chief Complaint Mary, a 27-year-old, married, woman presents to your office stating that she is troubled by headaches and fatigue. She says that she always feels tired and can't sleep well, often waking up early. She describes her headaches as dull, aching, and generalized. These symptoms began about three weeks ago and have been getting worse. She reports a lack of interest in her usual activities. She also reports that she is missing work due to fatigue and inability to concentrate. Although her two children are both in school, she is concerned that she is not spending quality time with them. She is worried that she might have "something bad" because she has difficulty concentrating and is having frequent crying spells. She reports not sleeping well and a loss of appetite, with a weight loss of 10 pounds in the last month.
Social History: The patient has no significant past medical or psychiatric history and takes no regular medications. She denies using alcohol or drugs. The patient has two elementary school-aged children.
Physical Examination: The patient is cooperative, alert, and oriented; no delusions or hallucinations, and her thoughts are goal-directed and logical. You note the patient has some psychomotor slowing. During the interview, the patient suddenly bursts into tears. She tells you that she has been feeling sad almost all the time. She states that her thoughts are full of worries, with feelings of hopelessness and worthlessness. She denies current suicidal ideation. All her lab values are within the normal range.
American Association of Colleges of Osteopathic Medicine. (2012). Case study: A tired mom.