Sandy Liu, a cardiac care unit nurse, notices that a

An adult patient with obsessive-compulsive disorder (OCD) presents for follow-up. They are well-known to the practice and are currently receiving cognitive behavioral therapy (CBT) but no pharmacotherapy. Today, they state that ever since losing their job 3 months ago, they have found it difficult to get up in the morning and have no energy to do things that they once found interesting. They describe feeling mildly depressed. The patient has no problems sleeping or eating and denies any suicidal ideation. They know that their savings are running out and that they don’t want to be on unemployment, but they just don’t see the point in applying for jobs that they think they are “just going to get rejected from anyway.” They live alone and have little contact with their family. Challenge a Friend Question Feedback What is the most likely diagnosis? • A. OCD with depressive aspect B. OCD and bipolar disorder c. OCD and major depressive episode D. OCD and adjustment disorder with depressed mood

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