Potential Diagnoses for Leticia
 Major Depressive Disorder:
o Rule-in: According to the DSM-V, depressed mood most of the day (feels “hopeless”), decrease in appetite,
insomnia (which could be causing the difficulty sleeping), psychomotor agitation (being slowed down, which
could be causing the difficulty verbalizing), fatigue and loss of energy, feelings of worthlessness
(“helplessness”), diminished ability to think or concentrate, recurrent suicidal ideation, and impairment in
social functioning (not meeting eyes, etc.) are all rule-in criteria for Leticia. In addition, feelings of guilt are
often associated with depressive disorders.
o Rule-out: Depressions could be caused by physical illness (hypothyroidism), substance abuse (overdose of
the sleeping pills), or substance abuse (which was not reported in the case study). Depression symptoms due
to physical illness could be possibly diagnosed as a mood disorder due to a general medical condition.
 Bipolar Disorder:
o Rule-in: The case study mentions hopelessness and a suicide attempt, which are both rule-in criteria for
bipolar disorder. Major depressive symptoms including insomnia (which could be causing the difficulty
sleeping), fatigue, feelings of worthlessness (“hopelessness” and “helplessness”), and diminished ability to
think are all seen in Leticia’s case.
o Rule-out: Hypothyroidism exhibits similar behavior; therefore, getting a blood test could rule-out bipolar
disorder. From the case study, there are no signs of mania including: little need for sleep, high self-esteem,
increased rate of speech, etc.