A 20-year-old man presented to the psychiatry outpatients department with a sense of unsettling alteration in his personality. He expressed feeling peculiar, as if he is not his usual self. Despite being anxious and tense, he was unable to identify the exact nature of this change. What term best characterizes this sensation?
A 25-year-old woman visits the clinic with her father. He suspects that his daughter may have autism as she spends most of her time in her room playing video games. He mentions that she is emotionally distant and unresponsive when he tries to talk to her about his concerns. She has no close friends and has never been in a romantic relationship. However, she has recently been promoted at work. When asked for her thoughts on the matter, she seems disinterested and just wants to leave. What is the probable diagnosis?
A 33-year-old woman, accompanied by her husband, visits her GP with unusual behaviour. Her husband reports that the changes have occurred mostly in the past week and he has never seen this behaviour before. He describes finding her walking around the house and talking to people who are not there. During the consultation, the patient appears distracted and occasionally smiles and waves at the wall behind the GP. There is no personal or family history of psychiatric illness. The patient does not seem distressed and politely asks if she can leave as she believes the appointment is a waste of time.
The patient takes loratadine 10 mg once daily for hay-fever, salbutamol and beclomethasone inhalers for asthma, and has recently started a combined oral contraceptive pill for contraception. She is also taking a course of prednisolone tablets following a recent exacerbation of her asthma. Which medication is most likely to be causing her symptoms?
A 50-year-old man has been hospitalized following an overdose. What is the most significant indicator of an increased likelihood of future suicide?
Following the 2011 NICE guidelines for managing panic disorder, what is the most suitable initial drug therapy for treating the condition in younger patients?
A 72-year-old female visits her GP due to concerns about memory loss. She has been experiencing forgetfulness and absent-mindedness for the past three weeks. She cannot recall conversations that occurred earlier in the day and has forgotten to lock her front door. Additionally, she has been feeling fatigued and has lost interest in her usual activities, such as going out for walks. Living alone, she is worried about the potential risks associated with her memory loss. Although initially appearing cheerful, she becomes emotional and starts crying while discussing her symptoms. The following blood test result is obtained: TSH 2 mU/L. What is the most probable cause of her presentation?
A 22-year-old first-year graduate student presents to the Student Health Clinic because she feels depressed. She describes feeling homesick and is so sad that it is interfering with her ability to focus, work or make new friends. Her sleep, appetite and energy have been unaffected. She denies suicidal ideation or feelings of guilt. She thought it would have gotten better by now, but she said it has already been 2 months since she left home and she is still unhappy. She is worried that she is experiencing major depression.
Which of the following is the most appropriate diagnosis?
Sarah is a 30-year-old teacher who has been referred to the mental health team with suspected bipolar disorder. The psychiatrist has confirmed the diagnosis and prescribed lithium, which has stabilized her condition. They have requested that you take over the monitoring of her medication levels. When you call Sarah to advise her on when to have her lithium levels checked, she cannot recall the specific timing related to her medication. How would you recommend that her medication levels be monitored?
As a healthcare professional, you are asked to evaluate a patient in their early 30s who is experiencing chest pain and is awaiting assessment by the psychiatry team. Upon examination and investigations, no abnormalities are found. However, you observe that the patient is exhibiting unusual behavior, avoiding eye contact and being hesitant to answer questions. After building a rapport with the patient, they reveal that they have never been in a romantic relationship and prefer to be alone to avoid embarrassment. They have no friends and do not communicate with their family due to constant criticism. What type of personality disorder is the patient likely experiencing?
A 25-year-old woman comes to her doctor’s office seeking assistance for her anxiety. She feels overwhelmed by her job, particularly when it comes to communicating with coworkers and superiors, as she is afraid of being criticized. In her personal life, she frequently worries about how her friends perceive her and often avoids socializing with them as a result. She admits to having low self-esteem and a negative self-image. What is the most appropriate diagnosis for her?