A 17-year-old boy visits his doctor complaining of low mood. He has been experiencing this for the past 5 weeks along with fatigue, anhedonia, and oversleeping. The doctor orders a set of blood tests and his PHQ-9 score indicates moderate depression. The patient has no medical history. He is not interested in cognitive behavioural therapy and wants to begin medication. What is the best medication for him to start with?
A 42-year-old man is brought to the Emergency Department by his friends. He holds a senior trading job in an investment bank and has a history of recurrent admissions following cocaine intoxication. They are worried because he recently sent a memo to everyone on the trading floor suggesting that he is now the lead, he has the mental capacity to beat anyone to a higher profit and he should be chairman of the group. In fact, he has been performing poorly and has missed recent performance targets.
Which of the following is the most likely diagnosis?
A 29-year-old woman presents with dry, eczematous hands. She reports being a very hygienic person, but since the onset of the COVID-19 pandemic, she has been washing her hands excessively – up to 60 times a day. She is aware that this is causing her skin to become dry and irritated, but her anxiety about contracting the virus is too great to stop. She works in a hospital and is worried about her colleagues noticing her frequent hand washing. You suspect she may have obsessive-compulsive disorder and decide to refer her to the community mental health team. What treatment options are likely to be offered to her?
A 52-year-old woman who is well known to the community mental health team is brought into the psychiatric hospital by her worried friends. She has not been eating more than a few mouthfuls of food a day for the last two weeks and refuses to speak more than a few words. She remains awake all night and rocks in her chair. She even refuses to drink more than a cupful of water per day despite numerous attempts by her friends, doctors and psychiatrists. She is refusing all oral medications. After a brief conversation, you feel she has capacity to make decisions. You learn she has a long history of depression which has been very severe at times.
Which of the following is the most appropriate treatment?
While working in psychiatry, you are taking a history from a patient with a new diagnosis of generalised anxiety disorder (GAD). You take a thorough past medical history. Which of the following is a risk factor for GAD development?
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 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?
A 72-year-old woman, widowed for 5 years, presents with insomnia, anhedonia, frequent tearfulness when discussing her late husband, and weight loss. She reports experiencing various nonspecific physical symptoms and expresses concerns about the return of breast cancer that was previously treated. She denies any substance abuse and denies having suicidal thoughts but admits that she would feel relieved if she were to pass away. What is the most suitable form of psychotherapy/treatment for this patient?
A 24-year-old medical student presents to the emergency department accompanied by his partner, reporting a 10-hour history of aggression, irritability, and hallucinations. The partner suspects a mental breakdown due to sleep deprivation from studying for exams. Laboratory tests for drugs and infection are negative. The patient is admitted for observation and returns to baseline the following day.
What is the probable diagnosis?