Generally your patient of the past two years has exhibited depression. She did, however, have one quite dramatic symptom that rules out a diagnosis of both major depressive disorder and dysthymia. This symptom is

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The best choice is C, mania, as it rules out a diagnosis of dysthymia, which requires the absence of manic symptoms, and major depressive disorder with mixed features or with psychotic features, which would require the presence of manic or psychotic symptoms, respectively. Option A, alcohol addiction, is not a symptom that rules out depression, as depression and alcohol use disorders are frequently comorbid. Option B, extreme sadness, is actually a core symptom of depression and would not rule out a diagnosis. Option D, comorbidity, is not a symptom but rather a term used to describe the presence of multiple disorders in one individual and does not rule out a diagnosis of depression.

Generally Your Patient of the Past Two Years Has Exhibited