A 7-year-old patient presents with sleep disturbances, poor school performances, decreased concentration, and a loss of pleasure in almost all activities. The nurse practitioner should suspect:

Rationale: A. Asperger syndrome is characterized by social interaction difficulties and restricted interests but does not typically include pervasive loss of pleasure or significant mood disturbances. B. Autism spectrum disorder (ASD) involves deficits in social communication and repetitive behaviors, but the core symptoms do not primarily include sleep disturbances, decreased concentration, or anhedonia. C. Pervasive developmental disorder (PDD) is an outdated term encompassing ASD and related disorders; mood symptoms are not central. D. Childhood depression is suggested by symptoms such as sleep disturbances, poor school performance, decreased concentration, and anhedonia (loss of pleasure in activities). Early recognition is crucial for timely intervention, including behavioral therapy or pharmacologic treatment if indicated.