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A 15-year-old girl is brought to a psychiatrist by her parents because they are concerned that she might be depressed.

A 15-year-old girl is brought to a psychiatrist by her parents because they are concerned that she might be depressed.

CASE 37 A 15-year-old girl is brought to a psychiatrist by her parents because they are concerned that she might be depressed. The parents had no complaints until 2 or 3 years ago. The patient’s grades have fallen because she cuts classes. She gets into fights, and her parents claim that she hangs out with the “wrong crowd”; some nights she does not come home until well past her curfew. The patient says that there is “nothing wrong” with her and that she wants her parents to “butt out of her life.” She claims that she is sleeping and eating well. She says she skips school to hang out with her friends and admits that they frequently steal food from a convenience store and spend time watching movies at one of their homes. She claims that she fights only to prove that she is as tough as her friends but admits that she often picks on younger students. She shows limited guilt or remorse about this. She seems cold and uncaring about how her behavior might affect others. She is not concerned about her grades and just wants her par- ents to “lay off” and let her enjoy her youth. She denies the use of drugs or alcohol other than occasionally at parties. Her blood-alcohol level is zero, and the results of urinalysis are negative for drugs of abuse. What is the most likely diagnosis? What treatment should be started?

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