A 23-year-old woman complains of depression and anxiety

A 23-year-old woman complains of depression and anxiety. While describing her symptoms, she looks dazed. A minute later, she looks around the room slowly, and says, in a heavily accented voice with a different tone, “Where am I?” Which of the following does this presentation suggest?

(A) adjustment disorder
(B) catatonia
© dissociative identity disorder
(D) major depression
(E) schizophrenia

Explanation:

© Dissociative identity disorder (multiple personality disorder) is often associated with memory disturbance and an alternate personality, who may have a different speech tone, accent, or voice. Schizophrenia (choice E) is unlikely; there is no sign of psychosis. Major depression (choice D) is unlikely; there is no sign of depression. Catatonia (choice B) refers to muscle rigidity and mutism, and adjustment disorder (choice A) is a broad diagnostic category that does not include this presentation.