A 28-year-old man comes to the physician with the chief complaint that he has been depressed for years. He notes that his mood is never good, though he has never seriously considered suicide. He often feels hopeless and has problems concentrating. His sleep pattern and appetite have not changed. He denies hallucinations of any kind. Based on this clinical picture, which of the following is the most likely diagnosis?
a. Conversion disorder
b. Avoidant personality disorder
c. Dysthymic disorder
d. Major depression
e. Adjustment disorder
the answer is below…
The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.
The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.
All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.
The correct answer is c; Dysthymic disorder.
Dysthymic disorder is characterized by a depressed mood for most of the day, for more days than not, for at least two years. While the effects of this mood disorder can be severe, including poor appetite, insomnia, low energy, fatigue, poor concentration, and hopelessness, the symptoms are not severe enough to meet the criteria for a major depression.