Rosh Psychiatry Board Practice Exam

In treating a patient with uncontrollable anger outbursts, what is the next best step?

1. Address appropriate communication

2. Begin pharmacologic treatment with a mood stabilizer

3. Begin pharmacologic treatment with an antidepressant

4. Refer the patient for psychotherapy

The correct answer is: Address appropriate communication

Addressing appropriate communication is crucial in managing uncontrollable anger outbursts. Anger often signals underlying issues related to interpersonal relationships, self-expression, and emotional regulation. By focusing on communication, the patient can learn to articulate feelings, needs, and frustrations in healthier ways, reducing the likelihood of explosive outbursts. Effective communication strategies can also include practicing active listening, using "I" statements to express feelings without blaming others, and developing conflict resolution skills. This foundational approach can help the patient better navigate situations that typically trigger anger, leading to improved social interactions and emotional stability. While pharmacologic treatments such as mood stabilizers or antidepressants can be beneficial in certain cases—especially if there's an underlying mood disorder—the initial step often involves cognitive and behavioral strategies. Similarly, psychotherapy referrals can provide long-term benefits, but before delving into specific therapies, enhancing communication skills can offer immediate support and is often preferable as a starting point.