Category: Uncategorized

Saylor Thrift is a popular musician whose fans look up to her and whose rival performers stand in awe of her success, particularly with younger generations. Saylor’s influence over her admiring “sailfish” or “thrifties” represents this form of power, which also operates to varying degrees in families, groups, and organizations:

Which of the following is NOT one of the key categories of symptoms for diagnosing autism?

Identify the disorder below and bullet point the symptoms that made you come to the diagnosis. There is only one answer. Loki from Thor has tried to commit suicide, is prone to self-sabotage and self-destruction, and tries to kill his brother Thor several times, but then is hurt when neither he nor his father visits him in prison. A lot of his aggression can be seen as frantic efforts to avoid abandonment by his family, especially by trying to push them away before they can do the same to him.

Identify the disorder below and bullet point the symptoms that made you come to the diagnosis. There is only one answer. A 63-year-old woman with advanced pancreatic cancer was referred for a psycho-oncology consultation due to her response, which seemed like sudden onset of loss of consciousness. On visiting her, she was found bedridden, staring at the ceiling without blinking, and responding minimally but correctly to our questions, including orientation-related ones such as date and location. Her family said that she suddenly became absentminded and stated to her husband, “It is over and I will probably die soon.” Medically, she did not have reduced consciousness. A neurological examination demonstrated that she maintained the position when the psycho-oncologist raised her hand (catalepsy). She had no medical history of psychiatric illness or alcohol or drug abuse, and she was very kind to others. Her husband said that she was very shocked at her diagnosis of pancreatic cancer and became anxious about treatment and admission to hospital. She had been afraid of cancer because her grandfather had died of cancer after a long period of suffering. She had been diagnosed with advanced pancreatic cancer accompanied by multiple liver metastasis 4 months before the event, and gemcitabine was administered. Three weeks before the event she had been admitted to our emergency department with thrombosis of both pulmonary arteries and stenosis of the third portion of the duodenum due to disease progression. She frequently vomited. Insomnia and anxiety reappeared, and after much agonizing, she decided to undergo a gastrointestinal bypass. The surgery proceeded 3 days before the event, without complication and post-operative delirium was not evident. After being treated for her suspected psychological disorder, she could sit on the bed and respond to our questions more clearly. Two days later, she was able to make expressions and smiled at her medical team. The symptoms disappeared 4 days later and did not reappear. One week later, she told her medical team about this experience and said that it was very scary. 

Identify the disorder below and bullet point the symptoms that made you come to the diagnosis.  Adam is an 18-year-old man who was banned from the family home after repeated physical attacks on his mother and has been living in his own apartment for several months. His male family members bring him food every day. Adam’s family contacted mental health services several times, but Adam will not engage with the services. Adam tells his mother several times that he will kill himself, but when being assessed under the Mental Health Act says that he was ‘kidding’ and just trying to get his mother’s attention. He later reports that the angels told him he needed to say this. He regularly complains about the neighbors being noisy, but the neighboring apartment is unoccupied. It is unclear whether he is hallucinating or has very sensitive hearing. He has threatened to ‘deal with the neighbors’ if nothing is done. He does not make eye contact with his family members or the doctors who are trying to help him. Additionally, Adam’s mental health staff encouraged him to see his primary care doctor because they noticed that his hands and forearms have become red and raw in places because he is washing his hands and arms frequently and for increasingly long periods of time. They have tried to divert him from this behavior, but he became anxious and quite agitated if interrupted when in a ‘washing routine’. This is a relatively new problem. While the staff is not worried about OCD, they are worried about repetitive behaviors, rigid thoughts, resistance to change, AND hallucinations. These issues have been present for multiple years, according to his family. Hint: Adam has 2 disorders.

Preventative measure for cognitive disorders favored by research findings include:

Identify the disorder below and bullet point the symptoms that made you come to the diagnosis. There is only one answer. Rorschach from Watchman views the world as one big cesspool of criminals and degenerates. His obsession with fighting crime is such that he seldom bathes or even eats or sleeps, and he suspects nearly every one of being guilty of something.

Identify the disorder below and bullet point the symptoms that made you come to the diagnosis. There is only one answer. “I know I won’t actually die, but it often feels like it.” – says Mona and nervously pats her auburn hair – “I can’t live without him, that’s for sure. When he is gone, it’s like life switching from Technicolor to black and white. There is no excitement, this electricity in the air that seems to constantly surround him.” She misses him so much that it physically hurts. Sometimes she feels like throwing up at the mere thought of separating or being abandoned by him. She is helpless without him: “He is so masterful and knows how to fix things around the house.” He is gorgeous and a great lover. Is he intellectually stimulating? Do they talk a lot? She moves uncomfortably in her seat: “He is more the silent strong type.” She is supporting him financially. “He is studying”. In the last seven years he had switched from psychology to political science to physical therapy. How long will she underwrite his quest for self-realization? “As long as it takes. I love him”.

Identify the disorder below and bullet point the symptoms that made you come to the diagnosis. There is only one answer. The White Rabbit from Alice in Wonderland is constantly worried about time, is inflexible on rules and orderliness, and does not partake in meaningless rituals.

The following set of questions are vignettes. For the vignettes, identify the disorder seen in each example (each example has only 1 answer unless otherwise specified) and bullet point the symptoms that made you come to the diagnosis.