1. Salient Features 14 year old, female Decreased Food Intake/ – Later refusal to eat Weight conscious Sad most of the day, – Progressive over months Apparent voices Distorted body image Increased irritability Cuts on arms and wrist Suicidal ideations Fainting No other apparent Const’lSx BMI = Underweight

2. Anorexia Nervosa 14 year old, female Decreased Food Intake/ – Later refusal to eat Weight conscious Sad most of the day, – Progressive over months Apparent voices Distorted body image Increased irritability Cuts on arms and wrist Suicidal ideations Fainting No other apparent Const’lSx BMI = Underweight …………+ …………+/– …………+ …………+/– …………– …………+/– …………+

3. Major Depressive Disorder in Children …………+ …………– …………+ …………+/– …………+ …………+/– …………– …………+/– 14 year old, female Decreased Food Intake/ – Later refusal to eat Weight conscious Sad most of the day, – Progressive over months Apparent voices Distorted body image Increased irritability Cuts on arms and wrist Suicidal ideations Fainting No other apparent Const’lSx BMI = Underweight

4. Anorexia Nervosa with Comorbid MDD in Children …………+ …………+/– …………+ 14 year old, female Decreased Food Intake/ – Later refusal to eat Weight conscious Sad most of the day, – Progressive over months Apparent voices Distorted body image Increased irritability Cuts on arms and wrist Suicidal ideations Fainting No other apparent Const’lSx BMI = Underweight

5. Primary Impression Anorexia nervosa, restrictive type; Major depressive disorder in Children

6. Differential Diagnosis

7. Bulimia Nervosa …………+ …………– …………+ …………+/– …………+ …………+/– …………– …………+/– …………– 14 year old, female Decreased Food Intake/ – Later refusal to eat Weight conscious Sad most of the day, – Progressive over months Apparent voices Distorted body image Increased irritability Cuts on arms and wrist Suicidal ideations Fainting No other apparent Const’lSx BMI = Underweight

8. General Medical Conditions …………+/– …………– …………+/– …………– …………+/– …………– …………+/– …………– …………+/– 14 year old, female Decreased Food Intake/ – Later refusal to eat Weight conscious Sad most of the day, – Progressive over months Apparent voices Distorted body image Increased irritability Cuts on arms and wrist Suicidal ideations Fainting No other apparent Const’lSx BMI = Underweight

9. Schizophrenia, Paranoid Type …………– …………+/– …………– …………+/– …………+ …………+/– …………– 14 year old, female Decreased Food Intake/ – Later refusal to eat Weight conscious Sad most of the day, – Progressive over months Apparent voices Distorted body image Increased irritability Cuts on arms and wrist Suicidal ideations Fainting No other apparent Const’lSx BMI = Underweight

10. Body Dysmorphic Disorder …………+ …………+/– …………+ …………+/– 14 year old, female Decreased Food Intake/ – Later refusal to eat Weight conscious Sad most of the day, – Progressive over months Apparent voices Distorted body image Increased irritability Cuts on arms and wrist Suicidal ideations Fainting No other apparent Const’lSx BMI = Underweight

11. Bipolar II Disorder …………+/– …………– …………+/– …………– …………+ …………+/– …………– …………+/– 14 year old, female Decreased Food Intake/ – Later refusal to eat Weight conscious Sad most of the day, – Progressive over months Apparent voices Distorted body image Increased irritability Cuts on arms and wrist Suicidal ideations Fainting No other apparent Const’lSx BMI = Underweight

12. Laboratory Tests Laboratory TestRationale CBC with differential count Baseline values; r/o infections, inflammation ElectrolytesBaseline; r/o electrolyte imbalance Blood urea nitrogenKidney function CreatinineKidney function; baseline Blood Glucoser/o hypoglycemia Liver function testsBaseline values Thyroid function testsr/o thyroid dysfunction