Make the Diagnosis: Multiple Trending Symptoms

(MedPage Today) -- Case Findings: A 45-year-old male presents to a primary care physician to re-establish care after 10 years. He claims he has been mainly healthy but too busy to engage in preventative care. However, he reports increased fatigue over the past 4 months; despite sleeping longer at night, he wakes up exhausted. He also complains of constipation. He denies any suicidal or homicidal thoughts, but says he has felt sad and worthless most of the day at least six days each week over the past month. Despite decreased appetite, he has gained approximately 10 pounds over the past month. Upon examination, his skin is dry and his jugular notch is not visible. His urine drug screen and alcohol level are negative. His LDL cholesterol is elevated, but his CBC is normal. What is the most likely diagnosis behind the depression?
Source: MedPage Today Psychiatry - Category: Psychiatry Source Type: news