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A Hispanic man comes into the emergency room complaining of headache, insomnia, fear, anger, and despair. Your differential diagnosis is most likely to include which one of the following?

A. Schizophrenia
B. Schizoaffective disorder
C. Panic disorder
D. Ataque de nervios
E. Myoclonic sleep disorder

1 Answer

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Final answer:

Given the presented symptoms and cultural context, the most likely diagnosis for the Hispanic man experiencing headache, insomnia, fear, anger, and despair is Ataque de nervios, which fits the description better than schizophrenia or the other listed disorders.

Step-by-step explanation:

The symptoms described in the question, which include headache, insomnia, fear, anger, and despair, do not align well with the symptom clusters typically associated with schizophrenia. Schizophrenia is characterized by symptoms that can include hallucinations, delusions, disordered thinking, and significant social or occupational dysfunction. The symptoms are more suggestive of Ataque de nervios, which is a cultural syndrome mostly observed among Latin American individuals. Ataque de nervios involves a sudden episode of intense emotional upset, including symptoms of anxiety, anger, trembling, and sometimes uncontrollable shouting and aggression. As it is rooted in the cultural background of the individual, this would be the most appropriate diagnosis from the options given.

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