Psychiatry

Answer 1 Major depression. Major depression is characterized by sadness, fatigue, sleep disturbance, and feelings of worthlessness.1 The case patient is experiencing obsessive thinking, but it is a different type than seen with OCD. His ruminations are excessive but logical, rather than absurd and irrational, which is a characteristic of true obsessions.2 His thought patterns are not suggestive of generalized anxiety disorder, which would require excessive worry about everyday life stressors. He does not have symptoms suggestive of delusional disorder or posttraumatic stress disorder. REFERENCES 1.  American Psychiatric Association. Diagnostic and statistcal manual of mental disorders. 4th ed., text rev. Washington (DC): The Association; 2000. 2. Hollander E, Simeon D. Anxiety disorders. In: Hales RE, Yudofsky, editors. Textbook of clinical psychiatry. Washington (DC): American Psychiatric Publishing; 2003:543-630. Click here to return to the questions

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