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

question 143

Multiple Choice

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)

---

Definitions:

Currency

The system of money in general use in a particular country, recognized as a medium of exchange for goods and services.

Alzheimer's Disease

A progressive neurodegenerative disorder characterized by cognitive decline, memory loss, and changes in behavior and personality.

Disorientation

A state of confusion or loss of sense of direction, often experienced in unfamiliar situations or as a result of cognitive impairment.

Mood Changes

Variations in a person's emotional state, ranging from happiness to sadness, which can occur due to various factors including stress, hormonal changes, or health conditions.