A 24-Year-Old Woman Is Seen for a Routine Physical Examination

A 24-year-old woman is seen for a routine physical examination before starting a new job.  In review of systems, she indicates intermittent headaches, occasional abdominal bloating, seasonal allergies, fatigue, and insomnia.  Her vital signs are within normal limits.  Examination and laboratory evaluation show no abnormalities.  During the visit, the physician notes that the patient seems sad.  She says, "I'm feeling low because a guy I was dating stopped returning my phone calls last week, but my mother said he wasn't my type anyway.  The truth is that I never feel good and have always had low self-esteem.  Ever since I started college 5 years ago, my energy is low and I always feel run down."  She has always been able to work and has a close relationship with her mother, with whom she lives.  Although the patient dates, she has never had a serious relationship and believes this is because she is unattractive and does not have much to contribute.  She has no thoughts of suicide.  Which of the following is the most likely diagnosis?

A) Adjustment disorder with depressed mood
B) Avoidant personality disorder
C) Dependent personality disorder
D) Major depressive disorder
E) Persistent depressive disorder (dysthymia)
F) Somatic symptom disorder