Question at position 4 During the past few years, Lester has experienced several episodes of devastating sadness, weight loss, feelings of worthlessness, and an inability to concentrate. Recently, Lester is experiencing tremendous elation, excessive excitement, racing thoughts, and elevated self-esteem. He has not slept for several days, claiming that he no longer needs a full night's sleep. Which diagnosis will Lester most likely receive from a clinical psychologist?Obsessive-compulsive disorderMajor depressive disorderBulimia nervosaBipolar disorder单项选择题
A
Obsessive-compulsive disorder
B
Major depressive disorder
C
Bulimia nervosa
D
Bipolar disorder

Question

Question at position 4 During the past few years, Lester has experienced several episodes of devastating sadness, weight loss, feelings of worthlessness, and an inability to concentrate. Recently, Lester is experiencing tremendous elation, excessive excitement, racing thoughts, and elevated self-esteem. He has not slept for several days, claiming that he no longer needs a full night's sleep. Which diagnosis will Lester most likely receive from a clinical psychologist?Obsessive-compulsive disorderMajor depressive disorderBulimia nervosaBipolar disorder单项选择题

A

Obsessive-compulsive disorder

B

Major depressive disorder

C

Bulimia nervosa

D

Bipolar disorder

BlackTom AI · Accepted Answer

Bipolar disorder is characterized by alternating episodes of major depression and mania or hypomania, so Lester’s mix of severe depressive symptoms followed by a period of extreme elation and decreased need for sleep points directly to that diagnosis.

1. Relevant knowledge points and concepts
- Major depressive episode: persistent sadness, weight change, feelings of worthlessness, impaired concentration.
- Manic/hypomanic episode: abnormally elevated/irritable mood, inflated self-esteem, decreased need for sleep, racing thoughts, increased goal-directed activity or risky behavior. DSM-5 distinguishes mania (often severe, ≥1 week or requiring hospitalization) from hypomania (≥4 days, less impairment).
- Bipolar disorder: presence of both depressive and manic/hypomanic episodes at different times.

2. Step-by-step reasoning
- Lester’s past episodes: “devastating sadness, weight loss, feelings of worthlessness, inability to concentrate” match criteria for major depressive episodes.
- His recent state: “tremendous elation, excessive excitement, racing thoughts, elevated self-esteem, has not slept for several days” meet criteria for a manic or hypomanic episode (notably decreased need for sleep and racing thoughts).
- The co-occurrence of both types of episodes in one individual is the defining pattern of bipolar disorder.

3. Calculations / intermediate steps
- No numerical calculations are required. The logical mapping is symptom → diagnostic criteria: depressive symptoms + manic symptoms = bipolar disorder.

4. Why the correct answer is correct
- Only bipolar disorder accounts for clear episodes of both depression and mania/hypomania in the same person. Lester’s symptom pattern exactly fits that alternating-mood characteristic.

5. Why other options are incorrect
- Major depressive disorder: explains only the depressive symptoms and cannot account for the recent manic-like symptoms.
- Obsessive-compulsive disorder: involves intrusive thoughts and repetitive behaviors/rituals, which are not described here.
- Bulimia nervosa: centers on bingeing and compensatory behaviors (purging), not mood swings or sleep loss.

6. Conclusion
- The diagnostic picture best fits bipolar disorder. This confirms the provided correct answer: Bipolar disorder.

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