1. According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), the time criterion to diagnose depression is if the patient has symptoms lasting for at least 2 weeks.

2. The mechanism of action of mirtazapine is central, presynaptic, alpha-2 receptor antagonism.

3. Priapism is one of the rare but serious side effects of trazodone.

4. A patient is said to have recurrent depression when he or she has two or more episodes of depression.

5. Of all the antidepressants, bupropion and paroxetine are less likely to precipitate a hypomanic or manic episode in patients with bipolar affective disorder.

6. Mirtazapine, although a sedating antidepressant, can be activated at doses higher than 30 mg.

7. The medications approved by the Food and Drug Administration (FDA) for the treatment of bipolar depression are lithium and lamotrigine.

8. Lithium and clozapine are known to specifically decrease suicidal ideation.

9. All patients presenting with depression should be screened for bipolar disorder.

10. Depression is twice as common in women compared to men.

11. Atypical depression is characterized by hypersomnia, hyperphagia, fatigue, and rejection sensitivity.

12. The risk of recurrence of depression after one episode is 50%. After two episodes, the recurrence risk increases to 70% to 90%.

13. The most important factor in predicting suicide is a past history of suicide attempt.

14. Of all the selective serotonin reuptake inhibitors (SSRIs), paroxetine is more likely to cause serotonin discontinuation symptoms because of the way it is metabolized.

15. Venlafaxine is a serotonin and norepinephrine reuptake inhibitor (SNRI).

16. Venlafaxine acts as an SSRI until the dose of 150 mg. A higher dose will inhibit the reuptake of norepinephrine.

17. All patients with depression should be screened for suicide risk.

18. The highest risk for suicide is associated with bipolar depression (20%), followed by major depressive disorder (15%) and schizophrenia (10%).

19. Cognitive behavioral therapy (CBT) has been found to be effective for patients with mild-to-moderate depressive disorders.

20. Dialectical behavioral therapy (DBT) has been found to be effective with patients who repeatedly harm themselves (especially patients who have borderline personality traits).

21. The risk of suicide increases with certain factors such as male gender, age (elderly individuals), physical health problems, chronic pain, lack of social support, access to firearms, and past history of suicide attempt.

22. Women attempt suicide more often than men, but men are more likely to complete suicide.

23. Comorbid alcohol and substance abuse greatly increases the risk of suicide.

24. Electroconvulsive therapy (ECT) is indicated for treatment-resistant depression. The most important predictor of response to ECT is a past history of response to ECT.

25. Vagus nerve stimulation (VNS) was recently approved by the FDA for depression. It is indicated for patients with chronic or recurrent depression who are at least 18 years old, who have a current episode of major depression that has not responded to an adequate trial of at least four different antidepressant treatments.

1. In a right-handed person, the left hemisphere is dominant in 90%, and the right hemisphere is dominant in 10%.

2. In a left-handed person, the left hemisphere is dominant in 64%, and the right hemisphere is dominant in 20%. In 16% of individuals, both hemispheres are dominant.

3. Frontal lobe damage results in changes in personality, perseveration; pallilalia, psychomotor retardation, and urinary incontinence.

4. Pallilalia is repetition of phrases and sentences.

5. Lesions in Broca’s area result in problems with verbal expression characterized by poor articulation and sparse speech.

6. Lesions in the dominant temporal lobe result in sensory or receptive aphasia.

7. Lesions within Wernicke’s area result in problems with decreased verbal comprehension and reading and writing abilities. Speech remains fluent but it is semantically inappropriate.

8. Lesions in the nondominant temporal lobe result in hemisomatognosia, prosognosia, and visuospatial problems.

9. Bilateral medial temporal lobe lesions cause amnesia.

10. Hippocampal lesions result in impaired memory of verbal information.

11. Gerstmann’s syndrome is a neurological disorder characterized by a lesion in the dominant parietal lobe, dyscalculia, agraphia, finger agnosia, and right-left disorientation.

12. Features of lesions in the dominant parietal lobe are motor aphasia, sensory aphasia, agraphia, alexia, apraxia, bilateral tactile agnosia, visual agnosia, and Gerstmann’s syndrome.

13. Features of lesions in the nondominant parietal lobe are anosognosia, hemisomatognosia, dressing apraxia, and prosopagnosia.

14. Anosognosia is failure to recognize a disabled limb.

15. Prosopagnosia is an inability to recognize faces.

16. Lesions in the dominant occipital lobe result in alexia without agraphia, color agnosia, and visual object agnosia.

17. Lesions in the nondominant occipital lobe result in visuospatial agnosia, prosopagnosia, metamorphosia, and complex visual hallucinations.

18. Metamorphosia is image distortion.

19. Klüver-Bucy syndrome results from bilateral ablation of temporal lobes including the uncus, amygdala, and hippocampus. It is characterized by oral tendencies, placidity, visual agnosia (and sometimes prosopagnosia), altered sexual activity, and hypermetamorphosis.

20. Apraxia is the inability to carry out purposeful voluntary movements, which cannot be accounted for by paresis, incoordination, sensory loss, or involuntary movements.

21. Ideomotor apraxia: lesion in parietotemporal lesions.

22. Ideational apraxia: lesion in temporoparietal.

23. Dressing apraxia: lesion in parietooccipital.

24. Constructional apraxia: lesion in parietooccipital.

25. Agnosia is an impaired recognition of an object despite an intact sensory system.

1. Sigmund Freud is the author of Mourning and Melancholia, Cocaine Papers, and The Psychopathology of Everyday Life.

2. According to Freud’s dream analysis, primary process thinking includes condensation, displacement, and symbolization.

3. Freud proposed three models: affect trauma, topographical, and structural.

4. The structural model is composed of id, ego, and superego.

5. Superego refers to conscience and ideals.

6. Defense mechanisms are functions of ego.

7. The basic defense mechanism is repression.

8. The defense mechanism of projection is associated with paranoia.

9. Homework is typically a part of treatment in cognitive behavioral therapy (CBT).

10. Analysis of transference is important in psychoanalytic psychotherapy.

11. Transference refers to the process whereby a patient displaces onto the analyst his or her feelings and ideas that derive from previous figures in life.

12. Countertransference refers to the therapist’s emotional attitude toward the patient, including his or her response to specific forms of the patient’s behavior.

13. Winnicott introduced the term, transitional objects and has argued, “There is no such thing as a baby.”

14. Melanie Klein, a pioneer in child psychoanalysis, coined the term projective identification.

15. Brief dynamic therapy has been shown to be effective in treating irritable bowel syndrome.

16. In chronic fatigue syndrome, CBT and graded exercise has been found to be helpful.

17. Ainsworth devised the Strange Situation Test to study the effects of separating primary school-aged children from their parents.

18. John Bowlby contributed extensively to the understanding of attachment behavior.

19. Konrad Lorenz proposed the theory of “imprinting.”

20. Joseph Wolpe was the original proponent of systemic desensitization.

21. Alcoholics Anonymous is an example of group therapy.

22. High expressed emotion (EE) in families of patients with schizophrenia is associated with poor prognosis.

23. EE in family members of patients with schizophrenia include criticism, hostility, and emotional overinvolvement.