A 29-year-old woman has been treated for "depression" for six years and has now been referred for electroconvulsive therapy after adequate trials of three antidepressants. Her mood shifts several times within a single day and always with what is happening between her and her boyfriend; she brightens completely when a friend calls in. Since her mid-teens she has described a persistent sense of emptiness, has cut her forearms after arguments, and has never held a job for more than a few months. Sleep, appetite and weight are unchanged. Which one of the following best explains her failure to respond?
Shared by Mornienmiddle twist
Filed under psychiatry › psychiatry › personality-disorders › personality-disorders

Keep going with ten more like this one.

Practise more

More from Psychiatry

See all

A 34-year-old man who came to Australia from Somalia six years ago is reviewed by his general practitioner for a depressive episode. After eight weeks of sertra…

Pre-internship · niche

A 40-year-old man who came to Australia from Iraq as a refugee eight years ago attends a general practice with six months of broken sleep, nightmares and daily…

Clinical rotations · middle twist

A 71-year-old woman who migrated from Hong Kong 40 years ago is admitted to a psychiatric ward with a severe depressive episode. She speaks Cantonese and almost…

Pre-internship · middle twist

A metropolitan mental health service is examining why Aboriginal and Torres Strait Islander inpatients leave the ward against medical advice far more often than…

Clinical rotations · middle twist

A 52-year-old man born in Vietnam, who has had schizophrenia for 25 years, comes to an emergency department with six hours of epigastric pain. He speaks limited…

Pre-internship · niche