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  #1  
Old 02-27-2012
tyagee's Avatar
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Psyche Depression, Bipolar, or Schizoaffective?

A 51-year-old woman presents with an episode of dysphoria, sleep difficulty, psychomotor agitation, and rumination about mistakes she has made in her life. She has delusions of guilt about indirectly causing the deaths of many people. She has a history of two previous episodes with similar symptoms, but no history of unusually elevated mood or increased activity. Between episodes, she is asymptomatic.
Which of the following is the most likely diagnosis?
(A) Bipolar II disorder, depressed phase
(B) Dysthymic disorder
(C) Major depressive disorder, recurrent
(D) Schizoaffective disorder, depressive type
(E) Schizophrenia

reason?
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  #2  
Old 02-27-2012
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id go for major depression, recurrant type... theres no mania or euphoria in between the depressive episodes... so bipolar is r/o.. also, there are gaps of no symptoms... so dysthymia r/o (continuous depression on majority days for >2yrs and patient always has hopelessness) schizoaffective and schizoprenia are r/o because the symptoms exclusively talk about depression...
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Old 02-27-2012
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the ans is major depression .....it cant be bipolar2..IN bipolar 2 pt has hypomani means manic episodes dnt reach to to the same severity as type 1 but pt does feel high n there is flight of ideas followed by severe depression n then a normal life...
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Old 02-27-2012
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i think its major depression recurrent.....as patient have depression features...

bipolar should have hypomaniac with depression ...

All schizo related will have some hallucinations and delusion associated with...

dysthemia seen almost for 2 yrs with depression like feature.....
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