Question:hard
A 25 year old lady presented with sadness, palpitation, loss of appetite and insomnia. There is no complaint of hopelessness or suicidal thought, and there is no past history of any precipitating event. She is remarkably well in other areas of life. She is doing her office job normally and her social life is also normal. What is the probable diagnosis in this case?
A 25 year old lady presented with sadness, palpitation, loss of appetite and insomnia. There is no complaint of hopelessness or suicidal thought, and there is no past history of any precipitating event. She is remarkably well in other areas of life. She is doing her office job normally and her social life is also normal. What is the probable diagnosis in this case?
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Autonomic arousal, no precipitant, no hopelessness or suicidal ideas, function intact.
Updated On: Jun 24, 2026
- Generalised anxiety disorder (GAD)
- Mixed anxiety and depression
- Adjustment disorder
- Mild depressive episode
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The Correct Option is A
Solution and Explanation
Read the vignette as a sorting problem between four near neighbours. The hard facts are: bodily over-arousal (racing heart, broken sleep, reduced appetite), some low mood, but no hopelessness, no suicidal thinking, no triggering life event, and a woman still functioning fully at work and socially.
Knock out depression first. A genuine depressive episode is anchored by sustained low mood with hopelessness, anhedonia or suicidal ideas and typically dents functioning; she has none of these markers and is functioning normally, so $mild\ depressive\ episode$ does not hold.
Knock out adjustment disorder next. It demands a named stressor within roughly three months of onset, and the stem explicitly denies any precipitating event, which removes it.
Mixed anxiety and depression is a category for blurred, subthreshold cases where neither side leads. Here one side clearly leads: the autonomic, arousal-heavy complaints. That points to generalised anxiety disorder, in which pervasive worry shows itself through palpitations, insomnia and appetite change, with mood symptoms riding along secondarily.
The dominant, free-floating somatic anxiety with preserved function names the disorder.
\[\boxed{Generalised\ anxiety\ disorder\ (GAD)}\]
Knock out depression first. A genuine depressive episode is anchored by sustained low mood with hopelessness, anhedonia or suicidal ideas and typically dents functioning; she has none of these markers and is functioning normally, so $mild\ depressive\ episode$ does not hold.
Knock out adjustment disorder next. It demands a named stressor within roughly three months of onset, and the stem explicitly denies any precipitating event, which removes it.
Mixed anxiety and depression is a category for blurred, subthreshold cases where neither side leads. Here one side clearly leads: the autonomic, arousal-heavy complaints. That points to generalised anxiety disorder, in which pervasive worry shows itself through palpitations, insomnia and appetite change, with mood symptoms riding along secondarily.
The dominant, free-floating somatic anxiety with preserved function names the disorder.
\[\boxed{Generalised\ anxiety\ disorder\ (GAD)}\]
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