PSYCHIATRY
4TH YEAR MEDICINE
Indeera Shankla
0
, Table of Contents
Aims and Learning Objectives ............................................................................................................................... 3
Learning Outcomes .............................................................................................................................................. 4
Knowledge....................................................................................................................................................... 4
Skills ................................................................................................................................................................ 5
Diagnosis, Classification & Formulation ....................................................................................................................6
Cognitive Assessment & Impairment ........................................................................................................................7
Attitudes ......................................................................................................................................................... 8
Basic Science.................................................................................................................................................... 9
Core Conditions ................................................................................................................................................. 10
Dementias ..................................................................................................................................................... 10
Fronto-Temporal Dementia ....................................................................................................................................11
Alzheimer’s Disease ................................................................................................................................................12
Dementia with Lewy Bodies ....................................................................................................................................12
Vascular Dementia ..................................................................................................................................................13
Delirium ........................................................................................................................................................ 14
Organic Mental Disorders............................................................................................................................... 16
Disorders due to psychoactive substance use (incl. alcohol) ............................................................................ 17
Alcohol addiction ....................................................................................................................................................17
Drug Addiction ........................................................................................................................................................19
Benzodiazepine Addiction .......................................................................................................................................20
Psychotic disorders ........................................................................................................................................ 21
Schizophrenia ..........................................................................................................................................................21
Schizoaffective Disorder..........................................................................................................................................24
Delusional Disorder .................................................................................................................................................25
Affective disorders ......................................................................................................................................... 26
Depression...............................................................................................................................................................26
Mania ......................................................................................................................................................................28
Bipolar Affective Disorder .......................................................................................................................................29
Neurotic disorders ......................................................................................................................................... 31
Generalised Anxiety Disorder .................................................................................................................................31
Panic Disorder .........................................................................................................................................................32
Phobias ....................................................................................................................................................................33
OCD .........................................................................................................................................................................34
PTSD ........................................................................................................................................................................35
Adjustment Disorders .................................................................................................................................... 36
Somatisation and Conversion disorders .......................................................................................................... 37
Dissociative Disorders .............................................................................................................................................37
Somatoform Disorders (Medically unexplained Symptoms) ..................................................................................38
Malingering .............................................................................................................................................................38
Munchausen Syndrome ..........................................................................................................................................38
Eating Disorders ............................................................................................................................................. 39
Personality Disorders ..................................................................................................................................... 41
Learning Disability ......................................................................................................................................... 42
Drugs ................................................................................................................................................................. 43
Basic Neurochemical Theories ........................................................................................................................ 43
Depression...............................................................................................................................................................43
Schizophrenia ..........................................................................................................................................................43
1
, Dementia .................................................................................................................................................................44
Commonly Used Psychotropic Drugs............................................................................................................... 45
Antidepressants ......................................................................................................................................................45
Antipsychotics .........................................................................................................................................................50
Mood stabilisers ......................................................................................................................................................53
Anxiolytics/hypnotics ..............................................................................................................................................55
Drugs for dementia .................................................................................................................................................57
General Drugs..........................................................................................................................................................58
Common psychoactive drugs used recreationally ............................................................................................ 59
Alcohol.....................................................................................................................................................................59
Cannabis ..................................................................................................................................................................59
Ketamine .................................................................................................................................................................60
Stimulants ...............................................................................................................................................................61
Opiates ....................................................................................................................................................................63
Benzodiazepines......................................................................................................................................................64
Legal highs ...............................................................................................................................................................65
OSCE.................................................................................................................................................................. 66
OSCE Stations ................................................................................................................................................ 66
Psychiatric History ......................................................................................................................................... 67
Depression History ......................................................................................................................................... 68
Anxiety History .............................................................................................................................................. 69
Psychosis History ........................................................................................................................................... 70
Mania History ................................................................................................................................................ 72
Eating Disorder History .................................................................................................................................. 73
Substance Misuse History............................................................................................................................... 74
Risk Assessment............................................................................................................................................. 76
Collateral History for Delirium / Dementia ...................................................................................................... 77
Cognitive Assessment .................................................................................................................................... 78
Mental Capacity ............................................................................................................................................. 79
Mental Health Legislation .............................................................................................................................. 80
Mental State Examination .............................................................................................................................. 81
Alcohol History .............................................................................................................................................. 83
Suicide Attempt / Deliberate Self Harm .......................................................................................................... 84
Explaining CBT ............................................................................................................................................... 85
Starting Anti-Depressants............................................................................................................................... 86
Starting Antipsychotics................................................................................................................................... 87
Starting Lithium ............................................................................................................................................. 88
Starting Clozapine .......................................................................................................................................... 89
ECT Counselling.............................................................................................................................................. 90
2
, Aims and Learning Objectives
Overall we want you
• to recognise the importance of mental health throughout medicine, such that from now you will routinely consider
this for every patient encounter
• to share our passion and enthusiasm for this subject
• ensure you have enough knowledge to be safe doctors of the future
• To become responsible, competent, reflective and safe clinicians in line with the GMC recommendations in
“Tomorrow’s Doctors”.
• To appreciate patients, carers and colleagues with understanding and respect at all times.
• To widen understanding of the bio-psycho-social management of common disorders.
• To develop an awareness of the interfaces at which health care is provided.
• To develop a population perspective and public health approach to health issues.
By the end of the course you should know how to
a. Obtain a background history (including past medical, psychiatric, personal and social histories)
b. Assess for, and initiate management of, depression
c. Assess for, and initiate management of, suicidal ideas
d. Assess for, and initiate management of, alcohol misuse
e. Assess for, and initiate management of, psychosis
f. Assess and report a mental state examination
g. Assess for, and initiate management, cognitive impairment
h. Assess and initiate management for a patient with delirium or acute confusion
i. Assess and initiate management for a patient with dementia or chronic confusion j. Assess capacity
3
4TH YEAR MEDICINE
Indeera Shankla
0
, Table of Contents
Aims and Learning Objectives ............................................................................................................................... 3
Learning Outcomes .............................................................................................................................................. 4
Knowledge....................................................................................................................................................... 4
Skills ................................................................................................................................................................ 5
Diagnosis, Classification & Formulation ....................................................................................................................6
Cognitive Assessment & Impairment ........................................................................................................................7
Attitudes ......................................................................................................................................................... 8
Basic Science.................................................................................................................................................... 9
Core Conditions ................................................................................................................................................. 10
Dementias ..................................................................................................................................................... 10
Fronto-Temporal Dementia ....................................................................................................................................11
Alzheimer’s Disease ................................................................................................................................................12
Dementia with Lewy Bodies ....................................................................................................................................12
Vascular Dementia ..................................................................................................................................................13
Delirium ........................................................................................................................................................ 14
Organic Mental Disorders............................................................................................................................... 16
Disorders due to psychoactive substance use (incl. alcohol) ............................................................................ 17
Alcohol addiction ....................................................................................................................................................17
Drug Addiction ........................................................................................................................................................19
Benzodiazepine Addiction .......................................................................................................................................20
Psychotic disorders ........................................................................................................................................ 21
Schizophrenia ..........................................................................................................................................................21
Schizoaffective Disorder..........................................................................................................................................24
Delusional Disorder .................................................................................................................................................25
Affective disorders ......................................................................................................................................... 26
Depression...............................................................................................................................................................26
Mania ......................................................................................................................................................................28
Bipolar Affective Disorder .......................................................................................................................................29
Neurotic disorders ......................................................................................................................................... 31
Generalised Anxiety Disorder .................................................................................................................................31
Panic Disorder .........................................................................................................................................................32
Phobias ....................................................................................................................................................................33
OCD .........................................................................................................................................................................34
PTSD ........................................................................................................................................................................35
Adjustment Disorders .................................................................................................................................... 36
Somatisation and Conversion disorders .......................................................................................................... 37
Dissociative Disorders .............................................................................................................................................37
Somatoform Disorders (Medically unexplained Symptoms) ..................................................................................38
Malingering .............................................................................................................................................................38
Munchausen Syndrome ..........................................................................................................................................38
Eating Disorders ............................................................................................................................................. 39
Personality Disorders ..................................................................................................................................... 41
Learning Disability ......................................................................................................................................... 42
Drugs ................................................................................................................................................................. 43
Basic Neurochemical Theories ........................................................................................................................ 43
Depression...............................................................................................................................................................43
Schizophrenia ..........................................................................................................................................................43
1
, Dementia .................................................................................................................................................................44
Commonly Used Psychotropic Drugs............................................................................................................... 45
Antidepressants ......................................................................................................................................................45
Antipsychotics .........................................................................................................................................................50
Mood stabilisers ......................................................................................................................................................53
Anxiolytics/hypnotics ..............................................................................................................................................55
Drugs for dementia .................................................................................................................................................57
General Drugs..........................................................................................................................................................58
Common psychoactive drugs used recreationally ............................................................................................ 59
Alcohol.....................................................................................................................................................................59
Cannabis ..................................................................................................................................................................59
Ketamine .................................................................................................................................................................60
Stimulants ...............................................................................................................................................................61
Opiates ....................................................................................................................................................................63
Benzodiazepines......................................................................................................................................................64
Legal highs ...............................................................................................................................................................65
OSCE.................................................................................................................................................................. 66
OSCE Stations ................................................................................................................................................ 66
Psychiatric History ......................................................................................................................................... 67
Depression History ......................................................................................................................................... 68
Anxiety History .............................................................................................................................................. 69
Psychosis History ........................................................................................................................................... 70
Mania History ................................................................................................................................................ 72
Eating Disorder History .................................................................................................................................. 73
Substance Misuse History............................................................................................................................... 74
Risk Assessment............................................................................................................................................. 76
Collateral History for Delirium / Dementia ...................................................................................................... 77
Cognitive Assessment .................................................................................................................................... 78
Mental Capacity ............................................................................................................................................. 79
Mental Health Legislation .............................................................................................................................. 80
Mental State Examination .............................................................................................................................. 81
Alcohol History .............................................................................................................................................. 83
Suicide Attempt / Deliberate Self Harm .......................................................................................................... 84
Explaining CBT ............................................................................................................................................... 85
Starting Anti-Depressants............................................................................................................................... 86
Starting Antipsychotics................................................................................................................................... 87
Starting Lithium ............................................................................................................................................. 88
Starting Clozapine .......................................................................................................................................... 89
ECT Counselling.............................................................................................................................................. 90
2
, Aims and Learning Objectives
Overall we want you
• to recognise the importance of mental health throughout medicine, such that from now you will routinely consider
this for every patient encounter
• to share our passion and enthusiasm for this subject
• ensure you have enough knowledge to be safe doctors of the future
• To become responsible, competent, reflective and safe clinicians in line with the GMC recommendations in
“Tomorrow’s Doctors”.
• To appreciate patients, carers and colleagues with understanding and respect at all times.
• To widen understanding of the bio-psycho-social management of common disorders.
• To develop an awareness of the interfaces at which health care is provided.
• To develop a population perspective and public health approach to health issues.
By the end of the course you should know how to
a. Obtain a background history (including past medical, psychiatric, personal and social histories)
b. Assess for, and initiate management of, depression
c. Assess for, and initiate management of, suicidal ideas
d. Assess for, and initiate management of, alcohol misuse
e. Assess for, and initiate management of, psychosis
f. Assess and report a mental state examination
g. Assess for, and initiate management, cognitive impairment
h. Assess and initiate management for a patient with delirium or acute confusion
i. Assess and initiate management for a patient with dementia or chronic confusion j. Assess capacity
3
