A young man seeks counselling because of marital discord. He and his wife have been having problems because he is uninterested in doing anything but playing video games. He has neglected his responsibilities at home and his work performance is beginning to suffer as well.
Which one of the following best describes his behaviour?
A 27-year-old woman has been experiencing a pattern of tumultuous endings in all of her relationships. She confides in you that she seems to have a knack for choosing friends and romantic partners who ultimately reveal themselves to be awful people.
What defense mechanism is most likely at play in this patient?
A 40-year-old mid-level manager is referred by his company after a recent incident. He had been working on a major project that would secure his promotion and position in the firm. After months of hard work, he was just about to finalize the project when his team member made a mistake that caused a setback. Frustrated by the setback, your patient began yelling, stomping on the floor and throwing objects until he broke a window.
Which one of the following ego defences best describes his behaviour?
A teenager has been referred because of bizarre behaviour at school. His teachers have reported that he alternates between very passive and very aggressive behaviours. At times, he cries and withdraws from sight when he thinks he is being slighted in some manner. At other times, he yells wildly and fights over the smallest of infractions. Upon further examination, you discover that the patient has been the victim of significant abuse at home.
Which one of the following defence mechanisms is he likely employing?
A 45-year-old woman presents to the Outpatient clinic with complaints of involuntary muscle movements of her tongue, fingers and trunk for the past 2 months. She was diagnosed with schizophrenia 10 years ago and has been on flupenthixol and then haloperidol, with good compliance. On examination, her temperature is 37.7 °C, blood pressure 115/80 mmHg and pulse 92 bpm. Her respiratory rate is 14 cycles/min. There is pronounced choreoathetoid movement of the hand and fingers.
What is the next line of management of this patient?
A 47-year-old woman presents complaining of ‘flashbacks’. Seven months earlier, she had been standing at a bus stop when a car swerved off the road into the queue, killing instantly a child standing near to her. Every day she experiences intrusive images of the child’s face as it saw the car mount the curb. She has not been able to go to that part of town since the day and she has avoided taking the bus anywhere. She feels she is always on edge and jumps at the slightest noise around the house. She thinks things are getting worse, rather than better, and asks you whether there are any psychological treatments that might help her.
Which one of the following approaches is indicated?
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?
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?
You are discussing bipolar disorder with your consultant in a geriatric trainees teaching session as part of your psychiatry attachment.
Which of the following is the most common medical treatment in the long-term management of bipolar disorder in older adults?
A 67-year-old male who has been on long term chlorpromazine presents with repetitive eye blinking. He is concerned about the cause of this symptom and reports being unable to control it. He has no visual disturbance and is otherwise in good health. Upon examination, he has a normal facial and ocular appearance except for excessive rapid blinking. What is the probable reason for his symptoms?