major depressive disorder

28 years old female teachers was brought to hospital presented with low mood for the past 1 month. All this happen after her father was died due to motor vehicle accident. She said that she had daily crying spell, felt sad all the time, and also had difficulty sleep at the night. she also said that her father died because of her fault and she try fix the mistake by hanging her self. She claimed that she cannot teach her student because of poor concentration in class and her relationship with her husband also become very bad.

1) describe 4 type of psychopathology seen in this patient
    - low mood
    - insomnia
    - suicidal attempt
    - poor concentration

2) what is your provisional diagnosis
    - major depressive disorder

3) give 2 differential diagnosis for this patient
    - substance abuse(alcohol abuse)
    - schizoaffective disorder
    - post-psychotic depression(depression following the treatment of psychotic symptoms)

4) what other information would you like to have which be useful in making diagnosis
    - ask about is it she had loss interest in all activity that she like to do(anhedonia)
    - ask about weight loss,weight gain
    - ask about decrease or increase appetite
    - ask about that she have any restlessness(psychomotor agitation),slowed down(psychomotor retardation)
    - ask about loss of energy
    - ask about feeling worthlessness
      *all symptoms occur nearly everyday

5) give principle management for this patient
    - admit patient to the psychiatric ward(suicide,homicide,deliberate self-harm)
    - give anti depressant for example SSRI(fluvoxamine,fluoxetine,ecitalopram)
    - give behavioral therapy, supportive psychotherapy, family therapy
    - if patient have high suicidal risk give ECT