A 32-Year-Old Man Comes to the Office for a Routine

A 32-year-old man comes to the office for a routine annual examination and is accompanied by his wife.  He has no new medical problems, and the physical examination is unremarkable.  At the end of the visit, the patient's wife asks to speak with the physician and expresses concern that her husband was recently placed on probation for poor work performance.  Over the past few years, the patient has become increasingly irritable and less interested in his work as an insurance agent.  She says, "He misses work at least once a week because he stays up all night playing poker online and then sleeps in during the day.  He talks nonstop about his betting strategies and how clever they are."  The patient has lost a lot of money, and they have started borrowing from her parents to pay the bills.  The patient denies that he has any problems and says, "I've just been a little down these past few weeks.  I know I can be on top again if I just get out of this slump.  I'm one of the best poker players around."  Which of the following is the best explanation for this patient's behavior?

A) Adjustment disorder with disturbance of emotions and conduct
B) Bipolar disorder
C) Cyclothymic disorder
D) Gambling disorder
E) Narcissistic personality disorder
F) Persistent depressive disorder (dysthymia)

Correct Answer:

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