A 21-year-old presents with complaints of an inflated self- esteem, decreased need for sleep, and distractibility.
The most likely diagnosis is
A) Depression
B) Hypothymia
C) Borderline personality
D) Mania
E) Antisocial personality
Answer and Discussion
The answer is D. Mania
The diagnosis of mania consists of a distinct period of abnormally and persistently elevated, expansive or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day.
During the period of mood disturbance and increased energy or activity, three or more of the following are present in sufficient degree and represent a noticeable change from usual behavior:
1. Inflated self-esteem or grandiosity
2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
3. More talkative than usual, or pressure to keep talking
4. Flight of ideas, or subjective experience that thoughts are racing
5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, foolish business investments)
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