Psychopharmacological Practice: The DSM Versus The Brain
The patient is a 50-year-old man who is presently admitted to psychiatric hospital because of severe MDD. He has suffered from MDD symptoms for 10 months consecutively with symptoms progressing from mild to incapacitating. He admits to having impaired concentration, marked fatigue, depressed mood with suicidal thoughts, insomnia, ruminations of worthlessness, and feelings of guilt. This is his first diagnosed depressive episode and he has had no drug treatment prior to this hospitalisation. He likely suffered from dysthymic disorder throughout his adult life. He is amicably separated and has three grown children who are doing well. His biological family suggests ADHD symptoms in a nephew and schizophrenia in an elderly uncle. He drinks alcohol occasionally, but there is no indication of misuse. He has mild obesity, and environmental allergies, but is otherwise healthy.