A 67-year-old woman, whose husband died 18 months ago, is admitted to the hospital because of severe headaches for 4 weeks. She
is quiet and seems sad. She believes that she has brain cancer, deserves to be punished for her sins, and is being punished by God for past misdeeds. She has had fatigue and a 6.8-kg (15-lb) weight loss over the past 4 months. Physical and neurologic examinations show no abnormalities. Most likely diagnosis?
If all medical explanations have been ruled out as the reason behind her health then the most likely diagnosis is a psychosomatic one which means her mental state is causing physical symptoms to appear that resemble medical ailments. This woman is bereaving the loss of her husband, she feels some sense of guilt as to how she has lived her life, she is depressed and most likely lonely. Psychologically she is not well and what she needs is intense mental health support. Once she feels better psychologically her physical issues should start to improve.
