Question 1:
What symptom distinguishes generalised anxiety disorder from major depression?
(A) insomnia
(B) weight loss
(C) overwhelming anxiety
(D) suicidal ideation
(E) overwhelming anhedonia
E: Major depression is a common coexisting condition, although major depression may be difficult to distinguish from generalized anxiety disorder because many symptoms of generalized anxiety disorder (e.g., fatigue and insomnia) overlap with those of major depression. Persistent anhedonia (the inability to experience pleasure), which is characteristic of major depression, is not a symptom of generalized anxiety disorder. Nevertheless, persons with generalized anxiety disorder are at increased risk for deliberate self-harm, including suicide attempts. In many patients, generalized anxiety disorder is an underlying waxing-and-waning condition, with episodic bouts of major depression emerging during particularly stressful life circumstances. This dual occurrence of generalized anxiety disorder and major depression constitutes what is sometimes referred to as “anxious depression,” a particularly common clinical presentation in primary care settings. N Engl J Med 2015; 373:2059-2068
Question 2:
Which of the following is a prognostic factor in schizophrenia?
(A) Sudden onset of illness
(B) Normal MRI scan
(C) Catatonic symptomatology
(D) Obesity
(E) Premorbid history of social isolation
E: A premorbid history of social isolation is a prognostic indicator. Sudden onset of illness is protective, as is being female, older age of first episode and predominantly positive compared to negative symptoms Journal of Clinical Psychiatry. 1996;57 Suppl 9:5–9
Question 3:
What is the prevalence of schizophrenia?
(A) 0.01%
(B) 0.1%
(C) 1%
(D) 5%
(E) 10%
C: Lancet 2014; 383: 1677-87
Question 4
Which of the following psychological therapies does NOT have level I evidence in the treatment of depression?
(A) Cognitive behaviour therapy
(B) Interpersonal psychotherapy
(C) Family-based therapy
(D) Brief psychodynamic psychotherapy
(E) Mindfulness based cognitive therapy
E: "Psychological therapies with Level I evidence for use in depression are cognitive behaviour therapy (CBT), interpersonal psychotherapy (IPT), family-based therapy (FBT) and brief psychodynamic psychotherapy (BPP). Mindfulness-based cognitive therapy (MBCT) has Level III evidence for depression" Med J Aust 2013; 199 (6 Suppl): S52-
Question 5
Which of the following psychological therapies is proven most useful in the treatment of borderline personality disorder?
(A) Dialectic behaviour therapy
(B) Mindfulness based cognitive therapy
(C) Interpersonal cognitive therapy
(D) Psychoanalysis
(E) Family based therapy
A: Dialectic behaviour therapy has the strongest evidence base for use. The other three psychotherapies include mentalisation based therapy, transference focused therapy and general psychiatric management. N Engl J Med 2011; 364:2037-2042
Question 6
What symptom distinguishes generalised anxiety disorder from major depression?
(A) insomnia
(B) weight loss
(C) overwhelming anxiety
(D) suicidal ideation
(E) overwhelming anhedonia
E: Major depression is a common coexisting condition, although major depression may be difficult to distinguish from generalized anxiety disorder because many symptoms of generalized anxiety disorder (e.g., fatigue and insomnia) overlap with those of major depression. Persistent anhedonia (the inability to experience pleasure), which is characteristic of major depression, is not a symptom of generalized anxiety disorder. Nevertheless, persons with generalized anxiety disorder are at increased risk for deliberate self-harm, including suicide attempts. In many patients, generalized anxiety disorder is an underlying waxing-and-waning condition, with episodic bouts of major depression emerging during particularly stressful life circumstances. This dual occurrence of generalized anxiety disorder and major depression constitutes what is sometimes referred to as “anxious depression,” a particularly common clinical presentation in primary care settings. N Engl J Med 2015; 373:2059-2068
Question 2:
Which of the following is a prognostic factor in schizophrenia?
(A) Sudden onset of illness
(B) Normal MRI scan
(C) Catatonic symptomatology
(D) Obesity
(E) Premorbid history of social isolation
E: A premorbid history of social isolation is a prognostic indicator. Sudden onset of illness is protective, as is being female, older age of first episode and predominantly positive compared to negative symptoms Journal of Clinical Psychiatry. 1996;57 Suppl 9:5–9
Question 3:
What is the prevalence of schizophrenia?
(A) 0.01%
(B) 0.1%
(C) 1%
(D) 5%
(E) 10%
C: Lancet 2014; 383: 1677-87
Question 4
Which of the following psychological therapies does NOT have level I evidence in the treatment of depression?
(A) Cognitive behaviour therapy
(B) Interpersonal psychotherapy
(C) Family-based therapy
(D) Brief psychodynamic psychotherapy
(E) Mindfulness based cognitive therapy
E: "Psychological therapies with Level I evidence for use in depression are cognitive behaviour therapy (CBT), interpersonal psychotherapy (IPT), family-based therapy (FBT) and brief psychodynamic psychotherapy (BPP). Mindfulness-based cognitive therapy (MBCT) has Level III evidence for depression" Med J Aust 2013; 199 (6 Suppl): S52-
Question 5
Which of the following psychological therapies is proven most useful in the treatment of borderline personality disorder?
(A) Dialectic behaviour therapy
(B) Mindfulness based cognitive therapy
(C) Interpersonal cognitive therapy
(D) Psychoanalysis
(E) Family based therapy
A: Dialectic behaviour therapy has the strongest evidence base for use. The other three psychotherapies include mentalisation based therapy, transference focused therapy and general psychiatric management. N Engl J Med 2011; 364:2037-2042
Question 6