Examkin

Soru

Zorluk: OrtaAnxiety, OCD, and Trauma-Related Disorders

A 24-year-old woman comes to the primary care clinic reporting feeling "constantly on edge" for the past 3 months. She states she has been worrying excessively about her academic performance, her finances, and her parents' health. The patient reports experiencing restlessness, muscle tension in her neck and shoulders, and difficulty concentrating on her studies. These symptoms began 3 months ago when she moved to a new city to start a rigorous graduate program. She acknowledges that the transition has been very stressful, and her academic performance has declined because she is so distracted by her worries. She denies any history of trauma, panic attacks, or periods of elevated mood. Her physical examination and laboratory studies, including thyroid-stimulating hormone, are within normal limits. Which of the following is the most likely diagnosis?

  1. Adjustment disorder with anxietyCevap
  2. B
    Generalized anxiety disorder
  3. C
    Acute stress disorder
  4. D
    Social anxiety disorder
  5. E
    Normal stress response

Cevap

Adjustment disorder with anxiety
The correct answer is adjustment disorder with anxiety. This patient presents with excessive worry, restlessness, muscle tension, and impaired concentration that began shortly after a major life stressor (moving to a new city for graduate school). Crucially, these symptoms have caused significant functional impairment (academic decline). Adjustment disorder is diagnosed when emotional or behavioral symptoms develop within 3 months of an identifiable stressor and cause marked distress or functional impairment, provided the symptoms do not meet the criteria for another specific psychiatric disorder. Because her symptoms have only been present for 3 months, she does not yet meet the 6-month duration requirement for generalized anxiety disorder.

Adım Adım Çözüm

1
Identify the primary symptoms and their duration.
The patient has excessive worry, restlessness, muscle tension, and poor concentration lasting for exactly 3 months.
Establishing the timeline and symptom profile is necessary to differentiate between various anxiety disorders.
2
Identify any triggering events and functional impact.
The symptoms began concurrently with moving for graduate school (an identifiable psychosocial stressor) and have caused an academic decline (functional impairment).
The presence of a stressor and functional impairment are key criteria for distinguishing pathology from a normal stress response.
3
Apply DSM-5 diagnostic criteria to rule out other disorders.
Generalized anxiety disorder requires 6 months of symptoms. Acute stress disorder requires a life-threatening trauma. Therefore, the presentation best fits an adjustment disorder.
Adjustment disorder is often a diagnosis of exclusion when symptoms triggered by a stressor do not meet the full duration or symptom criteria for another specific mental disorder.

Anahtar Kavram

Adjustment disorder is diagnosed when significant emotional or behavioral symptoms, leading to distress or functional impairment, develop within 3 months of a psychosocial stressor and do not meet criteria for another psychiatric disorder.
Tahmini Süre:1m 15s
Bu soruyu puanla

Konular

Anxiety, OCD, and Trauma-Related Disorders

Bu konudan daha fazla soru