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Psychology Quiz: Antidepressants and Compulsive Behaviors
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Psychology Quiz: Antidepressants and Compulsive Behaviors

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Questions and Answers

What is the most appropriate intervention for a patient who takes a second-generation antipsychotic for schizophrenia, has experienced weight gain, high BMI, high blood pressure, and elevated fasting glucose?

  • Begin insulin therapy
  • Stop antipsychotic medication
  • Education regarding diet and exercise (correct)
  • Begin a stimulant medication

    • Which diagnosis is most likely for a 23-year-old woman with symptoms of impulsivity, decreased need for sleep, excessive energy, rapid speech, grandiosity, and rhyming speech patterns, but no prior history of mood symptoms?

  • Bipolar I disorder (correct)
  • ADHD combined presentation
  • Bipolar II disorder
  • Schizoaffective disorder

    • Which disorder is most likely in a 22-year-old woman who develops sudden stuttering triggered by a class discussion on sexual harassment related to a past sexual assault?

  • Language
  • Somatic symptom
  • Conversion disorder (correct)
  • Illness anxiety

    • What is the most appropriate treatment for a 52-year-old man with acute agitation, restlessness, headache, tremors, and a history of alcohol consumption who experiences a generalized tonic-clonic seizure during assessment?

    <p>Lorazepam</p> Signup and view all the answers

    Which of the following is the most appropriate measure for a 49-year-old man with a history of IV drug use and current good health?

    <p>Hepatitis C testing</p> Signup and view all the answers

    Which of the following is the most appropriate diagnostic study for the patient with decreased visual acuity and sensitivity to painful stimuli over the skin of the right hand?

    <p>CSF analysis</p> Signup and view all the answers

    What is the most likely diagnosis for the 50-year-old woman with unintentional weight loss, inability to find pleasure in life, and extreme fatigue?

    <p>MDD</p> Signup and view all the answers

    Which treatment is most effective for the secondary prevention of drug use in high-risk adolescents?

    <p>Motivational interviewing within a harm-reduction setting</p> Signup and view all the answers

    What is the most likely diagnosis for the 28-year-old man with excessive hand washing and contamination fears?

    <p>OCD</p> Signup and view all the answers

    What is the most likely diagnosis for the 37-year-old woman with hallucinations, dry mouth, tachycardia, and urinary retention?

    <p>Anticholinergic intoxication</p> Signup and view all the answers

    What is most likely to be observed on the mental status examination of the 21-year-old man with elevated mood and grandiose thinking?

    <p>Pressured speech</p> Signup and view all the answers

    Which symptom is most likely present in a patient in the withdrawal phase after heavy cocaine use?

    <p>Dysphoria</p> Signup and view all the answers

    Which element in the history of the 16-year-old boy suggests possible self-medication with marijuana?

    <p>Feeling more normal with use</p> Signup and view all the answers

    What is the most appropriate initial intervention for a patient with acrophobia?

    <p>Exposure therapy</p> Signup and view all the answers

    In addition to psychotherapy, what is the most appropriate pharmaceutical therapy for the 16-year-old girl reporting depression symptoms?

    <p>Fluoxetine</p> Signup and view all the answers

    What is the expected result of a Snellen Test for a patient with new onset left eye blindness and previous 20/20 vision?

    <p>Left 20/20; right 20/200</p> Signup and view all the answers

    What is the most likely side effect of the recommended pharmacologic therapy for ADHD disorder?

    <p>Decreased appetite</p> Signup and view all the answers

    Which factor is most likely to play a role in the etiology of autism spectrum disorder?

    <p>Genetics</p> Signup and view all the answers

    For a 17-year-old girl with suspected anorexia nervosa, which condition poses the greatest risk?

    <p>Osteoporosis</p> Signup and view all the answers

    What is the most likely diagnosis for a 23-year-old male who exposes his genitals to passersby for sexual arousal?

    <p>Exhibitionistic disorder</p> Signup and view all the answers

    Following the father's massive MI, what symptom is most likely experienced by the 6-year-old girl?

    <p>Frequent temper tantrums</p> Signup and view all the answers

    For a 48-year-old man with paranoia and aggression, what is the most appropriate intervention?

    <p>Involuntary hospitalization</p> Signup and view all the answers

    Which medication requires an electrocardiogram prior to initiating high-dose therapy?

    <p>Citalopram</p> Signup and view all the answers

    Which substance is most likely responsible for a 15-year-old boy's intoxication with dysarthria, nystagmus, and confusion?

    <p>Phencyclidine</p> Signup and view all the answers

    For a 30-year-old woman seeking breast augmentation, what is the most appropriate next step in management?

    <p>Psychotherapy</p> Signup and view all the answers

    For a patient who overdosed on a tricyclic antidepressant, which of the following is the most appropriate initial diagnostic study?

    <p>Electrocardiography</p> Signup and view all the answers

    Which of the following meds is most likely to be used to diminish compulsive behaviors identified in patients with exhibitionistic disorder?

    <p>Fluoxetine (Prozac)</p> Signup and view all the answers

    Which of the following is a risk factor for attention-deficit/hyperactivity disorder?

    <p>Lead exposure</p> Signup and view all the answers

    Which of the following is recommended as an adjunct to the pharmacologic treatment for a patient with a diagnosis of GAD?

    <p>Mindfulness meditation</p> Signup and view all the answers

    A 28-year-old woman with difficulty sleeping and recurrent nightmares after being attacked by a dog 3 months ago is most likely diagnosed with:

    <p>PTSD</p> Signup and view all the answers

    More than half of all patients with a depressive disorder have an increase in levels of which of the following chemical mediators?

    <p>Serotonin</p> Signup and view all the answers

    Which of the following is a risk factor for the development of an anxiety disorder?

    <p>History of childhood abuse</p> Signup and view all the answers

    Which of the following medications has the greatest risk of fetal abnormalities when used during pregnancy?

    <p>Lithium (Lithobid)</p> Signup and view all the answers

    A 22-year-old woman who exercises frequently and eats only one meal a day, with worries about gaining weight and other concerns, is at risk for which comorbid condition?

    <p>Body dysmorphic disorder</p> Signup and view all the answers

    A 22-year-old college student with symptoms of sadness, decreased appetite, and difficulty concentrating after a breakup should be intervened with:

    <p>CBT</p> Signup and view all the answers

    A 5-year-old boy with hyperactivity, impulsivity, and inattention should have which of the following interventions recommended to the parents?

    <p>Charts and checklists to remember tasks</p> Signup and view all the answers

    Which of the following statements is most characteristic of persons with tobacco use disorder?

    <p>Cigarette smoking enhances nicotine delivery to the brain with levels peaking within 20 seconds of inhalation</p> Signup and view all the answers

    Which of the following neurotransmitters is most involved in the etiology of anxiety disorders?

    <p>Serotonin</p> Signup and view all the answers

    Which of the following is recommended for the treatment of a patient with antisocial personality disorder with no comorbidities?

    <p>No medication</p> Signup and view all the answers

    A 12-year-old boy showing aggressive behavior, irritability, animal cruelty, and fire-setting is most likely affected by:

    <p>Genetic predisposition</p> Signup and view all the answers

    Which of the following physical examination findings is expected for a patient with a history of alcohol use disorder?

    <p>Neuropathy, hepatosplenomegaly, and rhinophyma</p> Signup and view all the answers

    An 8-year-old boy presenting with disruptive behavior may require an initial evaluation for ADHD with which diagnostic study?

    <p>Evaluate for learning disorder</p> Signup and view all the answers

    A 22-year-old woman making multiple phone calls in the night, extravagant spending, and grandiosity may be diagnosed with:

    <p>Bipolar I disorder</p> Signup and view all the answers

    A 49-year-old woman struggling to make daily decisions without reassurance, feeling hopeless, and fearing ridicule may have which personality disorder?

    <p>Avoidant personality disorder</p> Signup and view all the answers

    A 17-year-old boy showing academic decline and behavioral changes related to marijuana use could benefit most from which intervention?

    <p>Counseling and behavioral interventions</p> Signup and view all the answers

    A 28-year-old woman presenting with chronic abdominal pain and worries of cancer likely has a history of:

    <p>Eating disorder</p> Signup and view all the answers

    A woman with depressed mood, suicidality, anhedonia, and hypersomnia alongside a history of psychosis is likely diagnosed with:

    <p>Schizoaffective disorder</p> Signup and view all the answers

    Which factor is most likely found in the history of a high school patient with anorexia nervosa?

    <p>Competitive gymnastics</p> Signup and view all the answers

    A 30-year-old man with a history of repeated arrests and use of an unregistered firearm would benefit from which diagnostic study to assess comorbid disorders?

    <p>Random drug screens</p> Signup and view all the answers

    A 12-year-old boy exhibiting bullying, fighting, and destruction of property is most likely diagnosed with:

    <p>Conduct disorder</p> Signup and view all the answers

    Which medication is the treatment of choice for a patient with an initial presentation of hypomania?

    <p>Lithium</p> Signup and view all the answers

    A 22-year-old man showing restlessness, disorientation, and symptoms of drug use most likely has signs and symptoms due to:

    <p>Amphetamine intoxication</p> Signup and view all the answers

    A patient with a stiff neck and musculoskeletal symptoms after starting haloperidol would benefit most from which intervention?

    <p>Benztropine intramuscularly</p> Signup and view all the answers

    A 28-year-old woman with chronic pain and headaches may benefit from which medication in addition to psychotherapy?

    <p>Topiramate</p> Signup and view all the answers

    A 16-year-old girl presenting with fever, abdominal pain, and blood-tinged diarrhea is most likely affected by:

    <p>Self-harm</p> Signup and view all the answers

    Which of the following is the most appropriate pharmacologic treatment for a patient with normal physical findings and laboratory results?

    <p>No pharmacologic therapy</p> Signup and view all the answers

    What is the most likely diagnosis for a 23-year-old man who is experiencing declining grades, self-care, hears voices, and refuses meals believing they are poisoned?

    <p>Schizophrenia</p> Signup and view all the answers

    Which of the following medications is most appropriate for treating a 60-year-old man with headache, palpitations, and agitation related to heavy alcohol use?

    <p>Lorazepam</p> Signup and view all the answers

    What should be included in patient education regarding atypical antipsychotics?

    <p>Monitor weight</p> Signup and view all the answers

    What is the most likely diagnosis for a 19-year-old woman with symptoms of waxy flexibility, no eye contact, and fear of being killed?

    <p>Schizophrenia</p> Signup and view all the answers

    Which diagnostic test is indicated to evaluate a patient with symptoms of an undiagnosed anxiety disorder?

    <p>Serum cortisol</p> Signup and view all the answers

    Functional neurologic symptoms of vision loss, paralysis, seizures, or abnormal movements are most consistent with which of the following?

    <p>Conversion disorder (functional neurological symptoms disorder)</p> Signup and view all the answers

    What is the most appropriate initial diagnostic study for a 28-year-old man with symptoms of agitation, restlessness, and palpitations after consuming an energy drink?

    <p>Urine toxicology</p> Signup and view all the answers

    Which neurotransmitter is associated with positive symptoms in patients with schizophrenia?

    <p>Dopamine</p> Signup and view all the answers

    What is the most likely diagnosis for a 16-year-old girl with weight loss, excessive exercise, distorted body image, and fear of gaining weight?

    <p>Anorexia nervosa restricting type</p> Signup and view all the answers

    What is the leading hypothesis for the etiology of schizophrenia?

    <p>Excess or deficiency of specific neurotransmitters</p> Signup and view all the answers

    Which neurotransmitter has been implicated in the etiology of manic disorders?

    <p>Gamma-aminobutyric acid</p> Signup and view all the answers

    In a patient with obsessive-compulsive personality disorder, which of the following is most likely to be revealed as part of the patient’s history?

    <p>Difficulty delegating tasks</p> Signup and view all the answers

    Which laboratory study is most appropriate to order when evaluating a patient with depression?

    <p>TSH</p> Signup and view all the answers

    What is the most likely diagnosis for a 25-year-old woman who believes she is pregnant despite negative tests and extensive workup?

    <p>Delusional disorder</p> Signup and view all the answers

    Children with separation anxiety disorder are at increased risk for which of the following?

    <p>Social anxiety disorder</p> Signup and view all the answers

    Which disorder is characterized by a history of sexual pleasure resulting from self-abuse?

    <p>Sexual masochism disorder</p> Signup and view all the answers

    Which of the following is a risk factor for the development of ADHD?

    <p>Positive family history</p> Signup and view all the answers

    During the active phase of schizophrenia, first-line medications are used to reduce which of the following symptoms?

    <p>Hallucinations, delusions, disorganized speech, agitation</p> Signup and view all the answers

    Which parental recommendation has been found to reduce the risk of feeding or eating disorders for high-risk individuals?

    <p>Maintain family meals including breakfast</p> Signup and view all the answers

    What is likely on the history of an 8-year-old boy with difficulty at school, distractibility, and worsening grades?

    <p>Enjoys building complex Lego sets</p> Signup and view all the answers

    What is the expected disease course for a 32-year-old man diagnosed with bipolar II disorder?

    <p>More frequent depression episodes</p> Signup and view all the answers

    Which diagnosis is most likely for a 37-year-old man with recent onset of palpitations, agitation, and depressed mood following personal stressors?

    <p>Adjustment disorder</p> Signup and view all the answers

    What is the most appropriate initial intervention for a disorder characterized by a paralyzing fear of social embarrassment?

    <p>CBT</p> Signup and view all the answers

    What medication may benefit a 40-year-old woman who believes she can read other people's minds and engages in unusual behavior?

    <p>Antipsychotic</p> Signup and view all the answers

    Which diagnostic study is most beneficial for evaluating an alternate source for anxiety in a 48-year-old woman with fatigue, weight loss, and treatment-resistant generalized anxiety disorder?

    <p>TSH</p> Signup and view all the answers

    What is the most appropriate first step in the management of the patient who denies suicidal and homicidal ideation but admits to inability to sleep, stomachaches, and palpitations?

    <p>Give reassurance and arrange follow-up</p> Signup and view all the answers

    What is the most appropriate first step in the management of the 14-year-old girl experiencing irritability, angry outbursts, and rule-breaking behavior?

    <p>Parent effectiveness training</p> Signup and view all the answers

    Which additional symptom is most likely present in the 24-year-old woman experiencing palpitations and diaphoresis when entering an elevator?

    <p>Tunnel vision</p> Signup and view all the answers

    What needs to be closely monitored in a patient taking valproic acid (Depakene)?

    <p>Liver function</p> Signup and view all the answers

    Which finding is consistent with a diagnosis of schizophrenia?

    <p>Cerebral ventricular enlargement</p> Signup and view all the answers

    What is the most likely diagnosis for the 40-year-old woman complaining of various symptoms and frequent visits to the Emergency Department?

    <p>Somatic symptom disorder</p> Signup and view all the answers

    What physical examination finding is most likely in the 22-month-old boy with sleeping and behavioral issues?

    <p>Avoidance of eye contact</p> Signup and view all the answers

    What is the most likely diagnosis for the 35-year-old man with a snake-related injury due to his lifelong fear of snakes?

    <p>Specific phobia</p> Signup and view all the answers

    Which personality disorder is the most likely diagnosis for the 35-year-old man with increased anxiety and work-related concerns?

    <p>Paranoid</p> Signup and view all the answers

    For which of the following is there the greatest evidence of positive correlation to antisocial personality disorder?

    <p>Heritability</p> Signup and view all the answers

    What is the most likely additional finding on physical examination for the 13-year-old girl with hair loss and thinning?

    <p>Thinning eyebrows</p> Signup and view all the answers

    What is the most likely diagnosis for the 49-year-old woman experiencing tearfulness, fatigue, and hopelessness following a breakup?

    <p>Major depressive disorder</p> Signup and view all the answers

    Which diagnostic study would help distinguish an exacerbation of schizophrenia from an organic etiology for the psychosis in the 47-year-old man?

    <p>Positron emission tomography scan</p> Signup and view all the answers

    Which personality disorder is most likely to lead a patient to refuse immunizations?

    <p>Paranoid</p> Signup and view all the answers

    What characterizes CBT in the treatment of alcohol use disorder?

    <p>Helps patients identify triggers and develop refusal skills</p> Signup and view all the answers

    What is the most likely pathophysiology causing irritability, anxiety, and insomnia in the 28-year-old man?

    <p>Decreased serotonin</p> Signup and view all the answers

    What is most likely to be found on ultrasound in a patient taking lithium?

    <p>Nephrolithiasis</p> Signup and view all the answers

    Which medication is most likely causing the rash and ulcerations in the 22-year-old woman with bipolar disorder?

    <p>Divalproex sodium (Depakote)</p> Signup and view all the answers

    After correcting caloric deficiencies in a patient with anorexia nervosa, what is indicated to stimulate bone anabolism?

    <p>Estrogen</p> Signup and view all the answers

    What is the most likely diagnosis for the 34-year-old woman convinced she has breast cancer despite no physical findings?

    <p>Illness anxiety disorder</p> Signup and view all the answers

    Which medication is an anxiolytic but is not a benzodiazepine?

    <p>Buspirone</p> Signup and view all the answers

    What is the most appropriate medication for the 53-year-old woman experiencing palpitations associated with public speaking?

    <p>Propranolol</p> Signup and view all the answers

    What is the most likely diagnosis for the 26-year-old woman with insomnia and persistent worries leading to disrupted sleep?

    <p>OCD</p> Signup and view all the answers

    Which of the following is the most appropriate treatment for the 15-year-old boy with angry outbursts, lying, and kicking his dog?

    <p>Reinforced positive behavior</p> Signup and view all the answers

    What is most important to screen for when evaluating a patient with depression?

    <p>Suicidal ideation</p> Signup and view all the answers

    Which of the following has been most closely associated with borderline personality disorder?

    <p>Frontal lobe dysregulation</p> Signup and view all the answers

    A 26-year-old woman 2 weeks postpartum with signs of depression is at greatest risk for which of the following with a future pregnancy?

    <p>Major depressive disorder with peripartum onset</p> Signup and view all the answers

    Which intervention would be most beneficial for the 67-year-old man preoccupied with rearranging everything in the kitchen?

    <p>CBT</p> Signup and view all the answers

    Which disorder is most consistent with the presentation of the 35-year-old man with constant fatigue, irritability, and worrying?

    <p>Generalized anxiety</p> Signup and view all the answers

    Which of the following is the most commonly experienced type of hallucination?

    <p>Auditory</p> Signup and view all the answers

    What is a common negative symptom of schizophrenia?

    <p>Diminished capacity to experience pleasure</p> Signup and view all the answers

    Which disorder is the most likely diagnosis for a 23-year-old man with acute, self-limited episodes resembling a heart attack?

    <p>Panic</p> Signup and view all the answers

    What is the pharmacologic treatment of choice for a 21-year-old woman with bulimia nervosa?

    <p>Fluoxetine</p> Signup and view all the answers

    What is most likely present in the history of a man with frotteuristic disorder?

    <p>Frequently rubbing against fully clothed women</p> Signup and view all the answers

    What is most important in the evaluation of a patient with a seizure and a history of factitious disorder?

    <p>MRI of the brain</p> Signup and view all the answers

    What is the most likely predisposing factor for a 30-year-old man with symptoms of anxiety after witnessing a traumatic event?

    <p>Intensity of the trauma</p> Signup and view all the answers

    What must be monitored weekly for a 34-year-old man starting on clozapine?

    <p>Absolute neutrophil count</p> Signup and view all the answers

    What is the most likely diagnosis for a 20-year-old man with bizarre behaviors, talking to himself, and paranoid thoughts?

    <p>Schizophrenia</p> Signup and view all the answers

    What is the most likely diagnosis for a 7-year-old girl with social withdrawal, intense focus, and refusal to be re-directed?

    <p>Autism spectrum disorder</p> Signup and view all the answers

    What is expected to decrease over time for patients with bipolar II disorder?

    <p>Duration of depression episodes</p> Signup and view all the answers

    What factor is most likely associated with the onset or exacerbation of obsessive-compulsive personality disorder?

    <p>Sleep disturbance</p> Signup and view all the answers

    In addition to cognitive-behavioral therapy, which medication is the appropriate treatment for a man with sexual urges towards girls near his workplace?

    <p>Sertraline</p> Signup and view all the answers

    Which disorder is most likely present in a woman with panic attacks in the lobby of her apartment building?

    <p>Agoraphobia</p> Signup and view all the answers

    What is the most appropriate screening test for a 45-year-old man with a long history of alcohol use disorder?

    <p>Liver function studies</p> Signup and view all the answers

    Which finding is most likely in the history of a patient diagnosed with paraphilic disorder?

    <p>Multiple atypical sexual urges</p> Signup and view all the answers

    What is the most likely diagnosis for a 72-year-old woman with sadness, insomnia, poor appetite, and weight gain after the death of her husband?

    <p>Major depressive disorder</p> Signup and view all the answers

    What physical examination finding would be consistent with the likely diagnosis of a stressed-out graduate student?

    <p>Tachycardia</p> Signup and view all the answers

    What is the most appropriate treatment for a patient diagnosed with somatic symptom disorder and a 6-month history of abdominal pain?

    <p>CBT</p> Signup and view all the answers

    What is the most likely diagnosis for a 19-year-old woman with fear of public speaking and social interactions?

    <p>Social anxiety disorder</p> Signup and view all the answers

    Which medication is contraindicated in a woman with panic disorder who is trying to conceive?

    <p>Paroxetine</p> Signup and view all the answers

    Voyeuristic disorder is characterized by sexual arousal through which of the following?

    <p>Watching an unsuspecting person undress</p> Signup and view all the answers

    What is most likely revealed in the history of a woman who avoids social interactions and views herself as inept and inferior to others?

    <p>Views herself as inept and inferior to others</p> Signup and view all the answers

    A man brought to the ED after an argument is goal-oriented and sad due to his grandmother's recent passing. What is his likely condition?

    <p>Adjustment disorder</p> Signup and view all the answers

    Study Notes

    Tricyclic Antidepressant Overdose

    • For a patient who overdosed on a tricyclic antidepressant, the most appropriate initial diagnostic study is an electrocardiography (ECG).

    Exhibitionistic Disorder

    • Fluoxetine (Prozac) is most likely to be used to diminish compulsive behaviors identified in patients with exhibitionistic disorder.

    Attention-Deficit/Hyperactivity Disorder (ADHD)

    • Risk factors for ADHD include:
      • Lead exposure
      • Secondhand smoke exposure after birth
      • Not birth order or obesity
    • Charts and checklists to remember tasks, and essential fatty acid supplementation are potential interventions for managing ADHD.

    Generalized Anxiety Disorder (GAD)

    • Mindfulness meditation is recommended as an adjunct to the pharmacologic treatment for a patient with GAD.

    Post-Traumatic Stress Disorder (PTSD)

    • A patient who experiences difficulty sleeping, recurrent nightmares, and avoidance of areas that may trigger memories of a traumatic event is likely to be diagnosed with PTSD.

    Depression

    • More than half of all patients with a depressive disorder have an increase in levels of cortisol.
    • A patient who has a history of depression, and an inability to express themselves due to fear of being ridiculed, is likely to be diagnosed with avoidant personality disorder.

    Anxiety Disorders

    • Risk factors for anxiety disorders include:
      • History of childhood abuse
      • Poor school performance
      • Not high SES, older age, or male gender
    • Serotonin is the neurotransmitter most involved in the etiology of anxiety disorders.

    Substance Use Disorders

    • Nicotine activates the brain's reward centers, increasing serotonin levels.
    • A patient who experiences difficulty making routine daily decisions without reassurance, and has a history of marijuana use, is likely to require counseling and behavioral interventions.

    Psychosis

    • A patient who has a history of psychosis, and experiences a decline in academic performance, is likely to be diagnosed with schizophrenia.

    Personality Disorders

    • A patient who is brought to the clinic due to unusual behavior, and has a history of making dozens of phone calls in the middle of the night, is likely to be diagnosed with bipolar I disorder.

    Antisocial Personality Disorder

    • A patient who has a history of multiple incarcerations, and an inability to conform to societal norms, is likely to be diagnosed with antisocial personality disorder.

    Conduct Disorder

    • A patient who has a history of frequent bullying, fighting, and destruction of school property, is likely to be diagnosed with conduct disorder.

    Hypomania

    • Lithium is the treatment of choice for a patient with an initial presentation of hypomania.

    Atypical Antipsychotics

    • Patient education regarding atypical antipsychotics should include monitoring weight.

    Conversion Disorder (Functional Neurological Symptoms Disorder)

    • Functional neurologic symptoms of vision loss, paralysis, seizures, or abnormal movements are most consistent with conversion disorder.

    Schizophrenia

    • The leading hypothesis for the etiology of schizophrenia focuses on excess or deficiency of specific neurotransmitters.

    Other Disorders

    • Children with separation anxiety disorder are at increased risk for social anxiety disorder.
    • An increase in gamma-aminobutyric acid (GABA) has been implicated in the etiology of manic disorders.### Adjustment Disorder
    • Adjustment disorder is a likely diagnosis for a 37-year-old man who recently experienced a divorce and a missed promotion, and is now experiencing depression, agitation, and work impairment.
    • Adjustment disorder is an appropriate diagnosis when a person's reaction to a stressful event is more severe than expected.

    Social Anxiety Disorder

    • Exposure therapy is a recommended treatment for a patient with a disorder characterized by a paralyzing fear of being embarrassed by one's actions in social situations.

    Borderline Personality Disorder

    • A 40-year-old woman with a history of intense, unstable relationships, inability to maintain a job, and suicide attempts may have borderline personality disorder.
    • Borderline personality disorder is characterized by a pattern of unstable relationships, emotions, and self-image.

    Eating Disorders

    • Bulimia nervosa is associated with a risk of developing complications such as electrolyte imbalance, gastrointestinal problems, and tooth decay.
    • A 40-year-old woman who unintentionally lost 15 pounds in the last 6 months, is unable to find pleasure, and is too fatigued to do daily activities may have major depressive disorder (MDD).

    Substance Use Disorders

    • A 56-year-old man who presents with anxious and diaphoretic appearance, tachycardia, tremor, and hyperreflexia, and experiences tonic-clonic seizure activity, is likely experiencing withdrawal from alcohol.
    • A 34-year-old woman who comes to the clinic with hallucinations, dry mouth, tachycardia, and urinary retention, and has dilated pupils and photophobia, may have anticholinergic intoxication.

    Psychotic Disorders

    • A 40-year-old woman who believes she can read other people's minds, lives alone, and has a disheveled appearance, may have a psychotic disorder, such as schizophrenia.
    • A 20-year-old man who has a 1-week history of elevated mood, grandiose thinking, and decreased need for sleep, may have a manic episode.

    Anxiety Disorders

    • A 16-year-old boy who is afraid of heights and has a history of self-medicating with marijuana may have an anxiety disorder, such as acrophobia.
    • A 28-year-old man who washes his hands at least 20 times a day, has unwanted thoughts about contamination, and has a fear of being contaminated by other people's germs, may have obsessive-compulsive disorder (OCD).

    Mood Disorders

    • A 16-year-old girl who reports difficulty getting out of bed, irritability, fatigue, and increased appetite, and has a history of talking to a school counselor, may have a mood disorder, such as depression.
    • A 45-year-old woman who comes to the office with fatigue, insomnia, loss of interest in activities, and feelings of hopelessness, and has a history of narcissistic personality disorder, may have a mood disorder, such as depression.

    Schizophrenia

    • A 20-year-old man who is brought to the clinic by his mother for bizarre behaviors, such as talking to himself, and believes that people are talking about him and tracking his whereabouts, may have schizophrenia.
    • A patient with schizophrenia who is taking clozapine should have their CBC monitored regularly.

    Somatic Symptom Disorder

    • A 29-year-old woman who is evaluated for a 3-month history of abdominal pain, and is persistently worried about the pain, and has a history of being raised in an orphanage, may have somatic symptom disorder.
    • A 35-year-old man who is evaluated for constant lower back pain, and refuses diagnostic tests, may have somatic symptom disorder.

    ADHD

    • A 58-year-old man who comes to the office with headaches and dizziness, and has a history of CNS injury, may have ADHD.

    • A comprehensive diagnostic evaluation for autism spectrum disorder must include assessments of cognitive function, social interaction, and communication.### Mental Health Disorders

    • Depression:

      • A 25-year-old woman experiencing difficulty sleeping, concentrating, feeling numb, and having recurring nightmares related to a past rape is likely to receive fluoxetine as the next step in management.
      • A 28-year-old woman with a history of depression, who refuses to feed her infant and stays away from the infant, is likely suffering from postpartum depression.

    • Anxiety Disorders:

      • Panic Disorder:
        • A 32-year-old woman experiencing anxiety, rapid pulse, and clammy hands after stopping therapy 3 months ago is likely to receive lorazepam and then escitalopram.
        • A 23-year-old man experiencing self-limited, recurrent episodes of chest pain, palpitations, and shortness of breath with no abnormal physical exam or diagnostic study findings is likely suffering from panic disorder.
      • Generalized Anxiety Disorder (GAD):
        • A 35-year-old man experiencing constant fatigue, irritability, difficulty concentrating, and excessive worry about his job, the health of his neighbor's dog, and the possibility of something bad happening to his parents is likely suffering from GAD.
      • Social Anxiety Disorder:
        • A 19-year-old woman experiencing fear of public speaking and curtails social interactions due to fear of saying something embarrassing is likely suffering from social anxiety disorder.

    • Psychotic Disorders:

      • Schizophrenia:
        • A 20-year-old man experiencing bizarre behaviors, talking to himself, and believing people are talking about him and tracking his whereabouts is likely suffering from schizophrenia.
      • Bipolar Disorder:
        • A 24-year-old man experiencing an elevated, expansive mood for 9 days after a depressive episode is likely suffering from bipolar disorder.

    • Personality Disorders:

      • Narcissistic Personality Disorder:
        • A person is more likely to develop narcissistic personality disorder due to genetic factors.
      • Borderline Personality Disorder:
        • Borderline personality disorder is closely associated with abnormal cholinergic activity.

    • Substance-Related Disorders:

      • Alcohol Use Disorder:
        • A 68-year-old man experiencing anxiety, headache, and nausea after abruptly stopping the consumption of 12 beers daily is likely suffering from alcohol withdrawal.

    • Trauma- and Stressor-Related Disorders:

      • Post-Traumatic Stress Disorder (PTSD):
        • A 35-year-old man experiencing signs and symptoms of depression 2 weeks postpartum is at greatest risk of acute psychotic episode, major depressive disorder with peripartum onset, panic disorder, and gestational diabetes in a future pregnancy.
        • A 30-year-old man experiencing irritability, anxiety, and flashbacks after witnessing a traumatic event is likely suffering from PTSD.

    • Dissociative Disorders:

      • Dissociative Amnesia:
        • A patient diagnosed with factitious disorder and experiencing tonic-clonic seizure-like symptoms is likely to have a normal prolactin level, indicating pseudoseizure.

    • Eating Disorders:

      • Bulimia Nervosa:
        • A 16-year-old girl hiding food wrappers and engaging in self-induced vomiting is likely suffering from bulimia nervosa.

    • Sleep-Wake Disorders:

      • Insomnia:
        • A patient experiencing difficulty sleeping, irritability, and excessive worry about his job, the health of his neighbor's dog, and the possibility of something bad happening to his parents is likely suffering from insomnia.

    • Screening Tests:

      • Liver Function Studies:
        • A 45-year-old man with a 20-year history of alcohol use disorder should have liver function studies performed.
      • Gamma-Glutamyl Transferase:
        • A patient with a history of alcohol use disorder should have gamma-glutamyl transferase levels monitored.

    • Medications:

      • Clozapine:
        • A patient started on clozapine 150 mg twice a day must have their absolute neutrophil count monitored weekly.
      • Fluoxetine:
        • A 25-year-old woman experiencing difficulty sleeping, concentrating, feeling numb, and having recurring nightmares related to a past rape is likely to receive fluoxetine as the next step in management.
      • Risperidone:
        • A 22-year-old woman with pedophilic urges and fantasies should receive risperidone as part of her treatment plan.

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    Test your knowledge of psychology and psychiatry with these questions on tricyclic antidepressants and treatment options for compulsive behaviors.

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