Mental Health

Cognitive behavior therapy interventions that include a narrative assessment are associated with a significantly reduced risk of suicide attempt.

• True
• False

Which one of the following statements about physician mental health is false?

• Those with feelings of loneliness were more likely to have manifestations of burnout.
• Loneliness is more likely in males.
• Female physicians are more likely to meet the criteria for alcohol use disorder.
• Physicians are at increased risk of suicide.

A 34-year-old man presents to your office for hospital follow-up. He was discharged one week ago following an episode of acute mania. He was diagnosed with bipolar disorder and was started on a single antipsychotic medication. He had one episode of depression in the past but has otherwise been healthy.

Bright light therapy can be an effective adjunctive treatment for nonseasonal depressive disorders.

• True
• False

In terms of mental health diagnoses, the most consistent effect from high doses of cannabidiol is some acute relief from anxiety.

• True
• False

Which one of the following statements about the management of insomnia is false?

• Mindfulness-based therapy has more data to support its efficacy than cognitive behavioural therapy for insomnia (CBT-I).
• Melatonin has been shown to have a small effect on sleep onset in adults.
• Complex behaviours during sleep, such as driving, are a patient-reported side effect of benzodiazepine receptor agonists.
• CBT-I used alone produces more sustained benefits than when used in combination with medication.

Which one of the following statements about trauma informed care in serious illness is false?

• A recommended screening question for trauma in serious illness is: “Have you ever experienced anything that makes seeing a health care provider difficult or scary to you?”.
• Being trauma-informed means presuming all patients have a history of trauma.
• The medical setting can trigger traumatic memories leading to hypervigilance.
• The stressors of the acute medical setting can increase hospital length of stay.

Strength training is an effective treatment for depression.

• True
• False

Which one of the following statements about adjunctive medications in difficult-to-treat depression is false? 

• Atypical antipsychotics are efficacious.   
• Lithium is a recommended drug.   
• Bupropion has mixed evidence for efficacy.   
• Mirtazapine has been shown to be efficacious. 

In patients with treatment-resistant depression, esketamine nasal spray plus an SSRI or SNRI is superior to extended-release quetiapine plus an SSRI or SNRI with respect to remission at eight weeks.

• True
• False

Which one of the following statements about Catatonia is false?

• It is a rare form of schizophrenia.
• Episodes may recur periodically.
• Remission with lorazepam challenges validates the diagnosis.
• Electroconvulsive therapy is effective after insufficient response to benzodiazepine administration.

Half of patients with a brief psychotic episode will only present with a single remitting event.

• True
• False

Lisdexamfetamine is an effective treatment in binge eating disorder.

• True
• False

Which one of the following statements about binge eating disorder (BED) is false?

• It has a female-to male ratio of approximately 5:1.
• Most people with BED meet the criteria for another psychiatric disorder.
• Less than 5% of those who meet the DSM-5 criteria for BED have received a diagnosis from a health care provider
• Current research supports the efficacy and cost effectiveness of self-help interventions such as books and smartphone apps as the first step in treatment of BED.

Which one of the following is not an effective intervention for treatment of insomnia among people with common mental disorders?

• Mindfulness-Based therapy for insomnia.
• Internet mindfulness meditation intervention.
• Mindfulness meditation.
• Mindfulness-based touch therapy.