Table Of ContentPsychiatry Review and
Canadian Certification
Exam Preparation Guide
This page intentionally left blank
Psychiatry Review and
Canadian Certification
Exam Preparation Guide
Edited by
James A. Bourgeois, O.D., M.D., F.R.C.P.C.
Usha Parthasarathi, M.B.B.S., F.R.C.P.C.
Ana Hategan, M.D., F.R.C.P.C.
Washington, DC
London, England
Note: The authors have worked to ensure that all information in this book is accurate at the time of publication and
consistent with general psychiatric and medical standards and that information concerning drug dosages, schedules, and
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Drug Administration and the general medical community. As medical research and practice continue to advance, how-
ever, therapeutic standards may change. Moreover, specific situations may require a specific therapeutic response not
included in this book. For these reasons and because human and mechanical errors sometimes occur, we recommend
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Copyright © 2012 American Psychiatric Association
ALL RIGHTS RESERVED
Manufactured in Canada on acid-free paper
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Library of Congress Cataloging-in-Publication Data
Psychiatry review and Canadian certification exam preparation guide / edited by
James A. Bourgeois, Usha Parthasarathi, Ana Hategan. — 1st ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-58562-432-4 (alk. paper)
I. Bourgeois, James. II. Parthasarathi, Usha. III. Hategan, Ana.
[DNLM: 1. Psychiatry—Canada—Outlines. WM 18.2]
616.890076--dc23
2011051210
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
Contents
Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Disclosure of Interests . . . . . . . . . . . . . . . . . . . . .xii
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
SECTION I
BASIC CLINICAL SCIENCE
1
Functional Neuroanatomy . . . . . . . . . . . . . . . . . . .3
Brian T. Harel, Ph.D.
Daniel Tranel, Ph.D.
2
Cultural Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Albert C. Gaw, M.D.
3
Psychiatry and the Law. . . . . . . . . . . . . . . . . . . . . 33
Robert I. Simon, M.D.
Daniel W. Shuman, J.D.
Ana Hategan, M.D., F.R.C.P.C.
Usha Parthasarathi, M.B.B.S., F.R.C.P.C.
4
The Psychiatric Interview
and Mental Status Examination. . . . . . . . . . . . . . 47
Linda B. Andrews, M.D.
Fred Ovsiew, M.D.
5
Laboratory Testing in Psychiatry . . . . . . . . . . . . . 57
H. Florence Kim, M.D.
Paul E. Schulz, M.D.
Elisabeth A. Wilde, Ph.D.
Stuart C. Yudofsky, M.D.
6
Clinical Neuroimaging . . . . . . . . . . . . . . . . . . . . . 79
Robin A. Hurley, M.D.
Ronald E. Fisher, M.D., Ph.D.
Katherine H. Taber, Ph.D.
SECTION II
PSYCHIATRIC DISORDERS
7
Disorders Usually First Diagnosed
in Infancy, Childhood, or Adolescence . . . . . . . . 89
Amy M. Ursano, M.D.
Paul H. Kartheiser, M.D.
L. Jarrett Barnhill, M.D.
8
Delirium, Dementia, and Amnestic and
Other Cognitive Disorders . . . . . . . . . . . . . . . . . 117
James A. Bourgeois, O.D., M.D., F.R.C.P.C.
Jeffrey S. Seaman, M.S., M.D.
Mark E. Servis, M.D.
Ana Hategan, M.D., F.R.C.P.C.
9
Substance-Related Disorders . . . . . . . . . . . . . . . 145
Martin H. Leamon, M.D.
Tara M. Wright, M.D.
Hugh Myrick, M.D.
Usha Parthasarathi, M.B.B.S., F.R.C.P.C.
10
Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Michael J. Minzenberg, M.D.
Jong H. Yoon, M.D.
Cameron S. Carter, M.D.
11
Mood Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . 191
John A. Joska, M.D., M.Med.(Psych.), F.C.Psych.(S.A.)
Dan J. Stein, M.D., Ph.D.
Usha Parthasarathi, M.B.B.S., F.R.C.P.C.
12
Anxiety Disorders . . . . . . . . . . . . . . . . . . . . . . . . 215
Eric Hollander, M.D.
Daphne Simeon, M.D.
Usha Parthasarathi, M.B.B.S., F.R.C.P.C.
13
Somatoform Disorders . . . . . . . . . . . . . . . . . . . .255
Sean H. Yutzy, M.D.
Brooke S. Parish, M.D.
14
Factitious Disorder and Malingering . . . . . . . . . 267
Barbara E. McDermott, Ph.D.
Martin H. Leamon, M.D.
Marc D. Feldman, M.D.
Charles L. Scott, M.D.
15
Dissociative Disorders. . . . . . . . . . . . . . . . . . . . . 277
José R. Maldonado, M.D.
David Spiegel, M.D.
16
Sexual Disorders . . . . . . . . . . . . . . . . . . . . . . . . . 293
Judith V. Becker, Ph.D.
Jill D. Stinson, Ph.D.
17
Gender Identity Disorders and Paraphilias . . . . 305
Judith V. Becker, Ph.D.
Bradley R. Johnson, M.D.
Usha Parthasarathi, M.B.B.S., F.R.C.P.C.
Ana Hategan, M.D., F.R.C.P.C.
18
Eating Disorders . . . . . . . . . . . . . . . . . . . . . . . . . 317
Katherine A. Halmi, M.D.
Ana Hategan, M.D., F.R.C.P.C.
19
Impulse-Control Disorders Not
Elsewhere Classified . . . . . . . . . . . . . . . . . . . . . . 331
Eric Hollander, M.D.
Heather A. Berlin, M.P.H., Ph.D.
Dan J. Stein, M.D., Ph.D.
20
Personality Disorders . . . . . . . . . . . . . . . . . . . . . 345
Andrew E. Skodol, M.D.
John G. Gunderson, M.D.
SECTION III
TREATMENTS
21
Psychopharmacology . . . . . . . . . . . . . . . . . . . . . 369
Melissa Martinez, M.D.
Lauren B. Marangell, M.D.
James M. Martinez, M.D.
Ana Hategan, M.D., F.R.C.P.C.
22
Nonpharmacological Somatic Treatments . . . . 427
Mark S. George, M.D.
Ziad H. Nahas, M.D., M.S.C.R.
Jeffrey J. Borckardt, Ph.D.
Berry Anderson, B.S.N., R.N.
Milton J. Foust Jr., M.D.
23
Psychodynamic Psychotherapy . . . . . . . . . . . . . 435
Robert J. Ursano, M.D.
Stephen M. Sonnenberg, M.D.
Susan G. Lazar, M.D.
24
Cognitive Therapy. . . . . . . . . . . . . . . . . . . . . . . . 449
Jesse H. Wright, M.D., Ph.D.
Michael E. Thase, M.D.
Aaron T. Beck, M.D.
SECTION IV
PRACTICE EXAM
Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 469
Answer Guide to Exam. . . . . . . . . . . . . . . . . . . . 495
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 567
Contributors
Berry Anderson, B.S.N., R.N. Ronald E. Fisher, M.D., Ph.D.
Clinical Research Manager, Central Study Coordinator Assistant Professor, Departments of Radiology and Neu-
for National Institute of Mental Health Optimization of roscience, Baylor College of Medicine, Houston, Texas;
Transcranial Magnetic Stimulation for the Treatment of Director of Nuclear Medicine, The Methodist Hospital,
Depression (OPT-TMS Depression) Study, Brain Stimu- Houston, Texas
lation Laboratory, Institute of Psychiatry, Medical Uni-
versity of South Carolina, Charleston, South Carolina Milton J. Foust Jr., M.D.
Assistant Professor of Psychiatry and Director, Electro-
Linda B. Andrews, M.D.
convulsive Therapy Program, Medical University of
Associate Dean for Graduate Medical Education and As- South Carolina, Charleston, South Carolina
sociate Professor, Menninger Department of Psychiatry
and Behavioral Sciences, Baylor College of Medicine, Albert C. Gaw, M.D.
Houston, Texas
Clinical Professor, Department of Psychiatry, University
of California, San Francisco, California
L. Jarrett Barnhill, M.D.
Professor of Psychiatry and Director of the Develop-
Mark S. George, M.D.
mental Neuropharmacology Clinic, Department of
Distinguished Professor of Psychiatry, Radiology, and
Psychiatry, Division of Child and Adolescent Psy-
Neurosciences; Director, Center for Advanced Imaging
chiatry, University of North Carolina, Chapel Hill,
Research; and Director, Brain Stimulation Laboratory,
North Carolina
Medical University of South Carolina (MUSC), Charles-
Aaron T. Beck, M.D. ton, South Carolina; Director, South Carolina Brain Im-
aging Center of Excellence; Chairman, National Institute
Professor of Psychiatry, University of Pennsylvania
of Mental Health Optimization of Transcranial Magnetic
School of Medicine, Philadelphia, Pennsylvania
Stimulation for the Treatment of Depression (OPT-TMS
Judith V. Becker, Ph.D. Depression) Study
Professor of Psychology and Psychiatry, Department of
Psychology, The University of Arizona, Tucson, Arizona John G. Gunderson, M.D.
Professor of Psychiatry, Harvard Medical School, Boston;
Heather A. Berlin, M.P.H., Ph.D.
and Director, Psychosocial and Personality Research,
Assistant Professor, Department of Psychiatry, Mount Si- McLean Hospital, Belmont, Massachusetts
nai School of Medicine, New York, New York
Katherine A. Halmi, M.D.
Jeffrey J. Borckardt, Ph.D.
Professor of Psychiatry, Weill Cornell Medical College,
Assistant Professor, Departments of Psychiatry and Anes-
White Plains, New York
thesiology, Medical University of South Carolina,
Charleston, South Carolina
Brian T. Harel, Ph.D.
Postdoctoral Fellow, Department of Neurology, Univer-
James A. Bourgeois, O.D., M.D., F.R.C.P.C.
sity of Iowa Hospitals and Clinics, Iowa City, Iowa
Professor of Psychiatry and Behavioural Neurosciences,
Michael G. DeGroote School of Medicine, McMaster
Ana Hategan, M.D., F.R.C.P.C.
University, Hamilton, Ontario, Canada
Assistant Clinical Professor, Department of Psychiatry
Cameron S. Carter, M.D. and Behavioural Neurosciences, Michael G. DeGroote
Professor of Psychiatry and Psychology and Director, Im- School of Medicine, McMaster University, Hamilton,
aging Research Center, University of California, Davis, Ontario, Canada
School of Medicine, Sacramento, California
Eric Hollander, M.D.
Marc D. Feldman, M.D. Clinical Professor and Director, Compulsive, Impulsive,
Clinical Professor of Psychiatry and Behavioral Sciences, and Autism Spectrum Disorder Program, Department of
Department of Psychiatry and Behavioral Medicine, Uni- Psychiatry and Behavioral Sciences, Albert Einstein Col-
versity of Alabama, Tuscaloosa, Alabama lege of Medicine, New York, New York
ix
