Psych - culture- bound syndromes and epidemiology of common conditions

Question 1

LIfetime risk of schizophrenia in the general population

Answer 1

1%

Question 2

The risk of schizophrenia in the identical twin of the affected
individual.

Answer 2

46%

Question 3

The lifetime risk of unipolar depression in the general population

Answer 3

10-20%

Question 4

incidence of anorexia nervosa in young females

Answer 4

0.5%. Affects females 10 times more than males

Question 5

Risk of Bipolar in identical twin

Answer 5

70% (0.3%-1.5% in general pop.)

Question 6

Untreated single episodes of this illness last between 4 and 30 weeks in mild to moderate cases. The risk of subsequent recurrence of similar episodes is roughly 30% at 10 years, rising to over 50% at 20 years.

Answer 6

Depressive episodes

Question 7

This illness is associated with a prognosis of 20% full recovery, 20% severely ill, and the remainder showing chronic fluctuations. If left untreated, the mortality rate is roughly 10–15%. Poorer prognosis associated with late age of onset and male gender.

Answer 7

Anorexia nervosa

Question 8

Long-term prognosis follows the pattern of 1/3 full recovery,
1/3 some improvement, and 1/3 remaining ill, although only
roughly 10–20% of those with a first episode will never relapse.
Death from suicide is increased 10-fold with this illness.

Answer 8

Schizophrenia (rule of thirds)

Question 9

Following an initial episode, the risk of a subsequent dis -
turbance is 90% (40–50% in the first 2 years). Each episode is roughly 6 months long. In a 25-year period, patients may experience roughly 10 episodes.

Answer 9

Bipolar affective disorder

Question 10

Around two-thirds of cases show improvement by the end of a
year, although 20–40% have a chronic course. Poor prognostic
factors are early onset, history of personality disorders, and persistent
life stressors, while better prognosis is predicted by good
premorbid social adjustment and episodic symptoms.

Answer 10

OCD

Question 11

A 42-year-old male of South East Asian origin believes that his penis is retracting into his abdomen and will disappear. He believes that this is an indication of impending death.

Answer 11

Koro

Also known as ‘genital retraction syndrome’ and the affected individual believes that his penis is retracting inside his body. This syndrome is experienced more commonly in young single males in Asia and the Middle East, although it has also been described in other countries. The individual may take measures to stop the penis from retracting by using splints or other devices. It is most likely to be due to an acute anxiety state but may also be associated with depression and schizophrenia

Question 12

A 27-year-old male of Native American origin believes that he
has undergone a transformation and has become a cannibal.

Answer 12

Windigo

A disorder thought to occur in the indigenous Native American population and is characterised by the fear or belief that one has been transformed into a creature that eats human flesh. It may be preceded by preoccupation with physical symptoms such as reduced appetite and nausea. It is thought to represent a form of depressive psychosis although no cases have been recorded.

Question 13

A 35-year-old male of South Asian origin presents with a period of withdrawal followed by indiscriminate homicidal behaviour, during which he kills others and himself.

Answer 13

Amok

disorder characterised by sudden unprovoked acts of violence, which may be preceded by a period of brooding or depression. The individual has amnesia for the event. It is thought to be a dissociative or depressive disorder, and is most commonly seen in males of South Asian, African, and New Guinean descent.

Question 14

A 50-year-old female of Inuit origin presents with a period of intense excitement, which is followed by apparent seizures and a transient coma.

Answer 14

Pibliotoq

also known as ‘arctic hysteria’ and has been described in females of polar Inuit origin. It is characterised by a period of excitement or impulsive acts such as tearing one’s clothes off, screaming and shouting, and running out into the snow. This may be followed by seizures and coma. It is thought to be an acute dissociative state.

Question 15

A 37-year-old female of Malaysian origin has a frightening experience and presents with echolalia, echopraxia, and automatic obedience.

Answer 15

Latah

described in Malaysian females and occurs following an experience of trauma. There is an exaggerated startle reaction, which may be accompanied by echolalia, echopraxia, and a trance-like state. It may represent an acute psychotic disorder or a dissociative disorder.

Question 16

described in men in the Indian subcontinent and refers to the belief that semen is being passed in urine. It is associated with lethargy, anxiety, hypochondriasis, and sexual dysfunction.

Answer 16

Dhat

Question 17

described in African students, usually at times
of stress such as examinations. The individual complains of poor
concentration and memory, headaches, and other somatic symptoms.
It is likely to represent anxiety or depression.

Answer 17

brain fag

Question 18

thought to occur in Central and South America following a stressful event. There is fear and anxiety associated with the belief that the soul had been stolen from the body.

Answer 18

susto

Question 19

described in South America and occurs following a stressor. There is a trance-like state, symptoms of anxiety, impulsiveness, and depression. It is thought to be a dissociative disorder.

Answer 19

ataque de nervios

Question 20

occurs in Japan and is the fear of embarrassing others with one’s appearance (body odour) or behaviour. It is thought to represent social phobia.

Answer 20

taijin kyofusho