Differential Diagnosis for Chloe
- Single Most Likely Diagnosis
- Major Depressive Disorder (MDD): This diagnosis is the most likely due to Chloe's reported history of depression and anxiety symptoms for about 10 years, her current symptoms of low mood, difficulties in motivation and enjoyment of activities, disrupted sleep and appetite, and her previous attempts at treatment with antidepressants.
- Other Likely Diagnoses
- Generalized Anxiety Disorder (GAD): Chloe's symptoms of worry about making mistakes at work, being judged by others, and a general on-edge feeling are consistent with GAD.
- Persistent Depressive Disorder (Dysthymia): Given Chloe's long history of depressive symptoms, dysthymia could be considered, especially if her symptoms have been persistent for most of the day, more days than not, for at least two years.
- Adjustment Disorder with Mixed Anxiety and Depressed Mood: This diagnosis could be considered given Chloe's recent job-related pressures and future uncertainties, which may be contributing to her anxiety and depressive symptoms.
- Do Not Miss Diagnoses
- Bipolar Disorder: Although Chloe denies any history of manic or hypomanic episodes, it is essential to consider bipolar disorder, as it can be deadly if missed, particularly if treated with antidepressants without a mood stabilizer.
- Post-Traumatic Stress Disorder (PTSD): Although not explicitly mentioned, it is crucial to screen for trauma, as PTSD can present with similar symptoms to anxiety and depression.
- Substance-Induced Mood Disorder: It is essential to assess for substance use, as it can contribute to or exacerbate depressive and anxiety symptoms.
- Rare Diagnoses
- Somatization Disorder: Although less likely, somatization disorder could be considered if Chloe's symptoms are primarily somatic in nature, and she has a history of multiple, recurrent physical complaints.
- Factitious Disorder: This diagnosis is rare but should be considered if Chloe's symptoms are inconsistent or fabricated, particularly if she has a history of seeking medical attention without a clear underlying condition.