A person in their mid-30s has been taking an anti-psychotic medication for a few years. They have also recently begun taking fluoxetine. During a visit to their general practitioner, they reported experiencing troubling symptoms such as lip smacking, difficulty swallowing, and excessive blinking. What is the probable diagnosis?
A 50-year-old man with schizophrenia who is on chlorpromazine experiences a bilateral resting tremor. Which side effect of antipsychotic medication does this exemplify?
A 30-year-old woman, with a history of hearing voices, was brought to the Emergency Department by her family. She described the voices as telling her to kill her father as ‘he has the devil in him’. She also reported noting her intelligence being tapped through the Internet by a higher power. This has been going on for the past 6 months. Her family denies either depression or manic episodes. The patient was admitted to an inpatient Psychiatry Unit and started on haloperidol for her symptoms, after an evaluation and diagnosis of schizophrenia. Twelve hours after initiation of therapy, the patient started to have stiffness in the neck muscles and spine. Physical examination revealed muscular spasms in the neck and spine, a temperature of 37.2 °C, blood pressure 125/70 mmHg and a pulse of 80 bpm.
What is the most likely diagnosis?
A 56-year-old man presents to the community mental health team with a history of obsessive-compulsive disorder (OCD). He reports obsessive thoughts about his family members being in danger and admits to calling his wife and daughters 3-4 times an hour to ensure their safety. Despite undergoing cognitive behaviour therapy (CBT) with exposure and response prevention (ERP), he still experiences distressing symptoms. The patient has a medical history of hypertension, hypercholesterolaemia, unstable angina, and pre-diabetes. What would be the most appropriate course of action for managing this man’s OCD?
As a core trainee on call in England, you are faced with a situation where a 35-year-old patient who is informally admitted and may be suffering from psychosis threatens to leave the hospital while being suicidal. What section of the Mental Health Act can be used to detain this patient?
A 29-year-old man is admitted to a psychiatry ward from the emergency department. He was brought by a concerned family member who was worried by his recent behaviour. He had been engaging in large amounts of shopping, spending nearly every night at the mall and hardly sleeping. When asked if he understands the risks of overspending, he is convinced that nothing can go wrong. He struggles to focus on the topic and begins rambling about buying various different items that are sure to make him happy. A diagnosis of a manic episode is made and he is stabilised on treatment with quetiapine. Subsequently it is decided to initiate lithium to maintain his mood.
When should his serum lithium levels next be monitored?