This page is dedicated to organizing various examples of standardized exam questions whose answer is dysthymic disorder. While this may seem a odd practice, it is useful to see multiple examples of how dysthymic disorder will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A 28 year old obese man comes to the foci because he has been “feeling blue” after being given a promotion. He feels as though he is always discouraged, and remembers that these feelings first started back in high school. The patient can remember only a handful of times where he did not feel sad- a month he spent with his grandparents in California, and a 2 month period when he felt “great” upon starting his first job. He has been working as a computer programmer since graduating from college. When he is not at work he is at home sleeping and estimates that he sleeps ~13 hours a day. The patient has never been out on a date because he thinks he will be rejected by women (due to his weight). He explains that he often feels hopeless about life, and overeats to cope with his feelings. Despite all of this, he enjoys playing video games, and even organizes video game tournaments with his coworkers and friends. The patient has no past medical history, and denotes using illicit drugs or alcohol. He has no suicidal ideation. There is a family history of major depressive disorder in both his father and younger sister. What is the most likely diagnosis?
Question # 2
A 32-year-old man comes to the clinic for the evaluation of a depressed mood. He states that at least since his mid-20s he has felt sad and depressed. He feels that he has a poor self-image and low energy, and feels hopeless about his life. He denies suicidal ideation. He does not use illicit drugs or alcohol, and has no past medical history. His last physical examination by his physician 1 month ago was unremarkable. Given this limited information, what is the most likely diagnosis?
A 25 year old woman comes to the clinic asking for antidepressants because she has a a longstanding depressed mood and low self-esteem. She explains that she has felt depressed and stressed since returning to her PhD program after the birth of her first child 3 years ago. She feels that her partner is not of much help, and she has decreased energy and a loss of interest in things she used to enjoy. She denies changes in sleep or appetite. Her past medical history is unremarkable. Physical exam is within normal limits. She has a full range of affect on a mental status examination, and there is no evidence of psychosis or suicidal ideation.
Explanation: this patient does show signs of depression, but does not seem to fulfill the criteria for Major depressive disorder. This has also been occurring for a long time which is very characteristic of dysthymic disorder.
Page Updated: 09.14.2016