A 31-Year-Old Woman Is Assessed for Difficulty Sleeping and Feeling

A 31-year-old woman is assessed for difficulty sleeping and feeling exhausted nearly every day for the past 6 months.  When the patient pushes herself to perform basic household tasks, she has no energy for the next 1 or 2 days and says, "My muscles ache for hours afterward."  She gets 6-7 broken hours of sleep a night and does not feel rested on awakening.  The patient also has intermittent headaches and difficulty concentrating.  Other than an episode of influenza 8 months ago, she has been in good health.
The patient describes feeling "down in the dumps" as she cannot go to the gym or socialize with friends as she once did.  She works as a counselor but has recently missed at least a day of work a week due to worsening exhaustion and body aches.  She enjoys her job and is anxious that the frequent absences will result in her termination; she asks the physician for a doctor's note.  The patient does not use tobacco, alcohol, or illicit drugs.
Vital signs and physical examination are unremarkable.
Laboratory results are as follows:
Which of the following is the most likely diagnosis in this patient?

A) Chronic fatigue syndrome
B) Fibromyalgia
C) Malingering
D) Persistent depressive disorder (dysthymia)
E) Somatic symptom disorder

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free