A 10-year-old female presents with history of major depressi…
A 10-year-old female presents with history of major depressive disorder, single episode that was diagnosed approximately 2 year ago. She originally presented with feeling sad and down most days of the week, some irritability, withdrawing to her room often, low self-esteem, and a decrease in interest for activities she typically enjoyed last year. Patient reports she still has some depressed periods but overall her depression has improved over the last year with her current medication regimen. However mother is concerned that within the last 12 months the patient has become increasingly irritable. The patient reports feeling annoyed or irritated almost daily and for most of the day. She has more frequent outbursts of anger in the last couple months and her anger seems to be triggered by minor incidents or being denied something she has requested. Mother also reports when she has her anger outbursts she will destroy property, scream, and slam doors. Majority of outbursts occur at home, but teachers have noted the change in mood and increase in “snapping” or getting angry with peers at school. Would you consider revising her diagnosis? If so, what would you update her working diagnosis list to?