Pancreatic cancer similarly to her late husband. What is the SINGLE most appropriate next step in management?

A 29 year old women has been taking selective serotonin reuptake inhibitors for the past 6 months for depression after the death of her husband 10 months ago. She feels her symptoms have improved and has decided to stop her medications. Several weeks after discontinuing her medications, she feels she has developed pancreatic cancer similarly to her late husband. What is the SINGLE most appropriate next step in management?

A. Restart selective serotonin reuptake inhibitors
B. Start on a tricyclic antidepressant
C. Neuropsychiatric analysis
D. Cognitive behavioural therapy
E. Start antipsychotics

This women requires a psychiatric referral i.e. Neuropsychiatric analysis. She is having a hypochondriacal delusion. Hypochondriasis can be defined as the persistent belief in the presence of an underlying serious DISEASE, e.g. cancer or HIV. Examples • A minor headache is caused by a brain tumour • A mild rash is the start of skin cancer • Tiredness is caused by HIV Reassurance by a doctor will not help a hypochondriac as a hypochondriac would fear that the doctor has just not found the evidence of a serious disease yet.