A 30-year-old woman presents to you with complaints of feeling down and fatigued. She struggles to fall asleep at night and has difficulty getting up in the morning. Despite her love for exercise, she lacks motivation and finds it hard to engage in physical activity.
What is the duration of her symptoms that would warrant a diagnosis of a depressive episode?
A 65-year-old-male presents to his GP with a chief complaint of forgetfulness over the past 3 months. He reports difficulty recalling minor details such as where he parked his car and the names of acquaintances. He is a retired accountant and reports feeling bored and unstimulated. He also reports difficulty falling asleep at night. His MMSE score is 27 out of 30. When asked to spell WORLD backwards, he hesitates before correctly spelling the word. His medical history includes hyperlipidemia and osteoarthritis. What is the most likely diagnosis?
Samantha is a 38-year-old female who has come to the crisis team with suicidal thoughts. Upon further inquiry, Samantha also reveals experiencing low mood, lack of energy, early morning awakenings, and difficulty concentrating. She reports that these symptoms are persistent, but she has both good and bad days. Samantha has no prior psychiatric history. What medication would be the most suitable to initiate treatment for Samantha?
A 22-year-old woman comes to the surgery, distressed that her midwife has advised her to stop taking sertraline at 10 weeks of pregnancy. She had taken it during her previous two pregnancies and had two healthy children. She insists on knowing the potential risks associated with sertraline use during the first trimester. What are the increased risks during this period?
A 28-year-old male patient visits the psychiatric clinic for a routine check-up. He reports experiencing weight gain, erectile dysfunction, and gynaecomastia. The patient was diagnosed with schizophrenia a year ago and has been struggling to find a suitable medication despite being compliant. He expresses concern that his partner is becoming increasingly frustrated with his lack of sexual interest, which is affecting their relationship. What is the most appropriate management option for this case?
You are requested to assess a 25-year-old man who has been urgently referred to the Community Mental Health Team. He has recently left his job to work on ‘a groundbreaking project’ which he believes will eradicate world poverty. He has also been neglecting his basic needs such as eating and sleeping as he ‘cannot afford to waste time on such trivialities’. Upon examination, the patient appears restless and lacks awareness of their condition. The patient has a history of depression and is currently on an antidepressant medication.
What would be the most suitable course of action in managing this patient?
A 55-year-old man with a history of paranoid schizophrenia experiences a recurrence of symptoms due to irregular medication intake, leading to his admission under section 2 of the Mental Health Act following a formal mental state assessment. He had been taking Risperidone orally once daily for several years, which had effectively stabilized his mental state while living in the community. Considering his non-adherence, what treatment option would be most appropriate for this individual?
A 29-year-old man presented to the hospital, accompanied by the police after having had a fight in a casino. The casino manager called the police when the man refused to leave after he had spent almost 24 hours gambling. The patient ran out of money and was harassing other clients, trying to borrow money from them and telling them that he will return it after he had won and invested the prize money. The patient has no known next of kin and refuses to engage with the attending doctor. He threatens to assault the medical staff and is eventually put under urgent mental health Section 4. A review of his medical notes reveals that the only medication on which he has been is lithium for a known psychiatric illness, but he has not been in touch with his general practitioner for the past two months.
What is the best course of action for managing this patient?
A 32-year-old man with a diagnosis of bipolar disorder is brought in by police under section 136 of the mental health act. His psychiatrist has recently adjusted his medication. He was found dancing in the middle of a busy street claiming to be the king of the world.
Upon assessment, he appears elated, his speech is rapid and he appears easily distracted. He believes he has been chosen by a higher power to save the world from destruction and hasn’t slept for days as a result.
The patient is sectioned and admitted to the mental health ward.
What is the most appropriate course of action?
A 28-year-old woman comes to her General Practitioner (GP) with her partner, concerned about her recent behavior. She has been having trouble sleeping for the past week and has been very active at night, working tirelessly on her new art project, which she believes will be a groundbreaking masterpiece. When questioned further, she admits to feeling very energetic and has been spending a lot of money on new materials for her project. Her partner is worried that this may be a recurrence of her known psychiatric condition. She is currently taking olanzapine and was recently started on fluoxetine for low mood six weeks ago. She has no significant family history. The couple has been actively trying to conceive for the past six months.
What is the most appropriate next step in managing this patient?