Which of the following has the highest risk of metabolic syndrome?

A. Clozapine (Clozaril) is a second-generation (atypical) antipsychotic with a high risk of weight gain, metabolic syndrome, and sedation due to its strong antagonism of histamine (H1) and serotonin (5-HT2C) receptors. It can also cause sexual dysfunction due to its impact on dopamine and prolactin levels.

B. Olanzapine (Zyprexa) has a significant risk of weight gain and metabolic side effects, similar to clozapine. It is known to cause hyperlipidemia, insulin resistance, and increased appetite, contributing to obesity. Sexual dysfunction can occur but is less common than with prolactin-elevating antipsychotics.

C. Haloperidol (Haldol) is a first-generation (typical) antipsychotic with a high risk of sexual dysfunction due to prolactin elevation from strong dopamine (D2) receptor blockade. While it has a lower risk of weight gain than atypical antipsychotics, it carries a high risk of extrapyramidal symptoms (EPS).

D. Aripiprazole (Abilify) is a partial dopamine agonist and has the lowest risk of weight gain among atypical antipsychotics. It also has a minimal impact on prolactin levels, reducing the risk of sexual dysfunction. Due to its unique mechanism, it is often preferred for patients concerned about metabolic side effects and sexual health.

A. Needs to be taken care of. Individuals with dependent personality disorder (DPD) have an excessive need for care and reassurance. They rely heavily on others to make decisions and take responsibility for their daily life.

B. Conflict avoidance. People with DPD avoid conflict and disagreement out of fear of losing support or approval from others. They may go to great lengths to maintain relationships, even if they are unhealthy.

C. Lacks remorse. Lack of remorse is more characteristic of antisocial personality disorder (ASPD), where individuals show little concern for the rights or feelings of others. In contrast, those with DPD tend to feel excessive guilt and anxiety rather than a lack of remorse.

D. Afraid to be alone. A strong fear of being alone is a core feature of DPD. Individuals may feel helpless or unable to function independently, leading them to tolerate mistreatment or stay in dependent relationships.