A 15-year-old girl is brought to the physician by her mother because of an 8-month history of fatigue; she has had a 6.8-kg (15-lb) weight gain during this period. The mother states that her daughter has been depressed for the past 2 months and recently failed a subject in school because she did not have the energy to complete a book report. The patient’s dog died 3 months ago. Her mother has major depressive disorder treated with paroxetine. The patient is 152 cm (5 ft) tall and weighs 68 kg (150 lb); BMI is 29 kg/m2. Her pulse is 50/min, and blood pressure is 100/50 mm Hg. Physical examination shows thinning hair and dry skin. Mental status examination shows a goal-oriented thought process and a depressed mood. Which of the following is the most likely cause of these findings?
A. Adjustment disorder
B. Bulimia nervosa
C. Chronic fatigue syndrome
E. Major depressive disorder
Correct answer : D. Hypothyroidism