WBR0926

Author	[[PageAuthor::Twinkle Singh, M.B.B.S. [1]]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Behavioral Science/Psychiatry
Sub Category	SubCategory::Neurology
Prompt	[[Prompt::26 year old female presents with fatigue from few months which started after her husband passed away in a car crash. She complains that she is not getting enough sleep as she wakes up early in the morning and finds it difficult to sleep again. She quit her job because she was finding it difficult to concentrate at work. She no longer feels like visiting her friends which she used to enjoy before her husband’s death and spends her entire day in the house. Her appetite has reduced and she has lost few pounds in the past few months. Which of the following is the most common sleep pattern found in this patient?]]
Answer A	AnswerA::↑ Total REM, ↑ Slow wave sleep
Answer A Explanation	AnswerAExp::Slow wave sleep is decreased in depression.
Answer B	AnswerB::↓ Total REM, ↓ Slow wave sleep
Answer B Explanation	AnswerBExp::Total REM is increased in depression
Answer C	AnswerC::↑ Total REM, ↓ Slow wave sleep
Answer C Explanation	AnswerCExp::Total REM is increased and slow wave sleep is decreased in depression
Answer D	AnswerD::↓ Total REM, ↑ Slow wave sleep
Answer D Explanation	AnswerDExp::Total REM is increased and slow wave sleep is decreased in depression
Answer E	AnswerE::No change in sleep patterns
Answer E Explanation	AnswerEExp::Changes in sleep pattern is very common in cases of major depressive disorders.
Right Answer	RightAnswer::C
Explanation	[[Explanation::This is a case of major depressive disorder. Diagnosis of major depressive disorder is made if at least 5 of the following symptoms are present for at least 2 weeks, depressed mood or lack of pleasure should at least be one of the 5 symptoms. S- Sleep disturbance (lack or excess of sleep) I- Loss of interest in previously enjoyable activities G- Feeling of excess guilt E- Loss of energy C- Inability to concentrate A- Appetite change (could be increased or decreased P- Psycho-motor agitation S- Suicidal tendency Sleep disturbance is very common in cases of depression. Sleep pattern changes in depression include: Early morning awakenings Decreased REM Latency Increased total REM REM is increased early in the sleep cycle. Decreased slow wave sleep Educational Objective: References: ]]
Approved	Approved::No
Keyword	WBRKeyword::Depression, WBRKeyword::Major depressive disorder
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::