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BRAIN AND BEHAVIOUR: Psychiatry

Index

• General Outcomes for Psychiatry
• Psychotic Disorders
• Anxiety Disorders
• Mood Disorders (inc. Depression)
• Delirium and Acute Confusion
• Dementia
• Personality Disorders
• Psychiatric Emergencies
• Somatoform and Factitious Disorders
• Eating Disorders
• Adjustment Disorders
• Learning Disabilities
• Substance Abuse and Dependence
• Suicide and Self Harm

• General Outcomes for Psychiatry
  • Medical knowledge: PATHOLOGY (TD 8.7)
    • General
      1. To achieve a basic understanding of brain function and pathological processes (PSYCH4)
      2. To understand the two-way links between Medical diseases and Psychiatric disorders (PSYCH4)
  • Medical knowledge: EPIDEMIOLOGY
    • Accidents and Suicide
      1. To understand the epidemiology of the psychiatric index conditions (PSYCH4)
  • Medical knowledge: PUBLIC HEALTH and GLOBAL HEALTH (TD 11 a-j)
    • Lifestyle and Disease
      1. To understand the role of stress and social deprivation etc on mental health (PSYCH4)
  • Medical knowledge: PSYCHOLOGY (TD 9 a-g)
    • Addictive Behaviour
      1. Understand the concept of addiction in its social context. (BB2)
      2. Understand the principles of learning and conditioning as applied to addiction (BB2)
      3. Examine individual differences in vulnerability to addiction (BB2)
      4. Be able to discuss the main treatment approaches and their limitations (BB2)
    • Drug Dependence
      1. Define drug dependence, drug tolerance and drug abuse.
      2. Be able to list the major classes of drugs that are subject to abuse.
      3. Give specific examples of central nervous system depressants, central nervous system stimulants and other types of drugs associated with dependence.
      4. Describe the major neuronal pathways involved in the effects of drugs with dependence potential.
      5. Have an overview of various treatments for addiction
    • General Principles of Psychology of Pain
      1. Discuss the psychosocial factors that modulate the perception of pain.
  • Clinical skills: HISTORY (TD 13 a-b)
    • Taking a History
      1. Be able to obtain a full psychiatric history.
      2. Achieve a balance between listening and interrupting. To orientate, guide and structure the interview within a time frame. (PSYCH4, PSYCH4)
      3. Be able to elicit psychiatric signs and symptoms (PSYCH4)
      4. Communicate with patients who have psychiatric disorders: obtain information, provide reassurance and establish rapport (PSYCH4, PSYCH4)
      5. Deal with dilemmas of confidentiality and detaining patients. (PSYCH4, PSYCH4)
      6. Establish the relationship and in particular to judge the distance both interpersonally and physically that is appropriate when interviewing patients with mental health problems. (PSYCH4, PSYCH4)
      7. Screen for psychiatric symptoms in a sensitive way (PSYCH4, PSYCH4)
      8. To know how to make a cultural formulation as part of a psychiatric assessment.
      9. Demonstrate skills necessary for dealing with aggressive and uncooperative patients (PSYCH4, PSYCH4)
  • Clinical skills: MENTAL STATE EXAMINATION (TD 13 d)
    • Mental State Examination
      1. Be able to perform a mental state examination
      2. Develop an overview of how the mental state examination is constructed
      3. Be able to assess a patient's potential danger to self or others. (PSYCH4)
      4. Be able to assess suicide risk. (PSYCH4)
      5. Have an understanding of some of the common signs elicited in mentally unwell patients including abnormalities of behaviour, mood state, thinking, perception and belief
      6. Develop an ability to distinguish between signs indicative of mental illness and experiences which arise from normal responses to stress/life events
      7. Be able to assess the seriousness of a suicide attempt. (PSYCH4)
      8. Be able to perform a cognitive assessment. (PSYCH4)
      9. Develop an understanding of how mental state examination contributes to the diagnosis of common mental illnesses
      10. Be able to present the history and examination findings in a coherent and comprehensive format, both written and oral. (PSYCH4)
  • Clinical skills: PLANNING AND INTERPRETING INVESTIGATIONS (TD 14 c-d)
    • Psychiatric Investigations
      1. Know the investigations used in psychiatry and be able to interpret their results. (PSYCH4, PSYCH4)
  • Clinical skills: MAKING A DIAGNOSIS and CLINICAL JUDGEMENT (TD 14 e-f)
    • General Outcomes for Psychiatric Diagnosis
      1. Give a differential diagnosis of common psychiatric disorders with supporting reasons. (PSYCH4, PSYCH4)
  • Clinical skills: FORMULATING A TREATMENT PLAN (TD 14 g)
    • Management of Psychiatric Disorders
      1. Know the general management of ANY psychiatric disorder over the first 24 hours of presentation (PSYCH4)
      2. Know, as a non-specialist, how to treat a patient with a psychiatric illness (PSYCH4)
      3. Understand the principles and practical application of the Mental Health Act in patient care (PSYCH4)
    • Psychiatric Emergencies
      1. To know the differential diagnosis of psychiatric emergencies and strategies for treating them (PSYCH4)
  • Professional issues: ETHICS and LAW (TD 20 a-g)
    • Ethics in Psychiatry
      1. The legislative requirements for compulsory admission
      2. Describe the key Sections of the Mental Health Act (including Section 2, Section 3, Section 5(2), with specific reference to admission, compulsory treatment. (PSYCH4)
      3. Know how the structure of the Act is designed to try to protect the civil liberties of detained patients. (PSYCH4)
      4. To describe the key Sections of the Mental Health Act, with specific reference to admission, compulsory treatment and to provide a moral justification for them.
      5. Know the conditions for detention of a patient Consider dilemmas of confidentiality and detaining patients. (PSYCH4)
      6. Know the indications for, and appropriate steps to be taken when compulsory admission under the Mental Health Act into hospital is required. (PSYCH4)
      7. To specify the implications of serious mental disorder for the interpretation of the duties of clinical care.
      8. Deal with dilemmas of confidentiality and detaining patients.
• Psychotic Disorders
  • General Outcomes for Psychotic Disorders
    1. To define correctly the term “psychosis” (PSYCH4, PSYCH4)
    2. To list the features that distinguish schizophrenia from a mood disorder with psychotic features (PSYCH4)
    3. To list the features that distinguish schizophrenia, delusional disorder, schizophreniform disorder, schizoaffective disorder and brief psychotic disorder from each other (PSYCH4)
    4. Know when and how to use antipsychotic drugs (oral and depot) and know their side effects (PSYCH4, PSYCH4)
    5. To formulate a differential diagnosis for an individual presenting with psychosis (PSYCH4, PSYCH4)
    6. Describe an appropriate course of treatment for a patient with schizophrenia including pharmacotherapy and psychosocial support (PSYCH4, PSYCH4)
    7. To understand the role stress, social deprivation etc on mental health
  • Schizophrenia
    1. Describe the symptoms of schizophrenia.
    2. To list the features that distinguish schizophrenia from a mood disorder with psychotic features (PSYCH4)
    3. Describe the pharmacology of typical and atypical antipsychotic drugs
    4. Describe an appropriate course of treatment for a patient with schizophrenia including pharmacotherapy and psychosocial support (PSYCH4, PSYCH4)
    5. To summarise the current knowledge concerning aetiology, pathogenesis and epidemiology of schizophrenia. (PSYCH4, PSYCH4)
    6. To summarise the clinical features and course of schizophrenia. (PSYCH4)
  • Psychosis
  • Pharmacological Management
• Anxiety Disorders
  • General Outcomes for Anxiety Disorders
    1. Define anxiety and list the main types of anxiety disorders.
    2. Anxiety Disorders: Be able to elicit psychiatric symptoms and signs of a patient with an anxiety disorder or obsessive compulsive disorder (PSYCH4, PSYCH4)
    3. Anxiety Disorders: Know when and how to use anxiolytic drugs and know their side effects. (PSYCH4)
    4. Anxiety Disorders: To describe the treatment, both pharmacological and psychotherapeutic, for each of the anxiety disorders (PSYCH4)
    5. Anxiety Disorders: To discuss the diagnosis and management of panic disorder, agoraphobia, social phobia and specific phobias. (PSYCH4)
    6. To understand the difference between fear and anxiety and the importance of this distinction (PSYCH4)
    7. Anxiety Disorders: To summarise current knowledge of the aetiology, pathophysiology and epidemiology of generalized anxiety disorder, panic disorder, social phobia, agoraphobia and other specific phobias (PSYCH4, PSYCH4)
  • Obsessive-Compulsive Disorder (OCD)
    1. Obsessive-Compulsive Disorder: To summarise current knowledge of the aetiology, pathophysiology and epidemiology of obsessive-compulsive disorder. (PSYCH4)
    2. Obsessive-Compulsive Disorder: To describe the treatment, both pharmacological and psychotherapeutic, of obsessive-compulsive disorder. (PSYCH4)
    3. Obsessive-Compulsive Disorder: To discuss the diagnosis and management of obsessive-compulsive disorder. (PSYCH4)
  • Pharmacological Management of Anxiety Disorders
    1. Describe the mechanism of action of benzodiazepines.
    2. Discuss the use of benzodiazepines as anxiolytics, hypnotics and sedatives.
    3. Compare the pharmacological profile of barbiturates and benzodiazepines.
    4. Describe non-benzodiazepine hypnotics and anxiolytics.
• Mood Disorders (inc. Depression)
  • General Outcomes for Mood Disorders
    1. To understand the classification of mood disorders and distinguish between unipolar depression and bipolar disorder (PSYCH4, PSYCH4)
    2. Review the neurobiology of depression.
    3. To list the features that distinguish schizophrenia from a mood disorder with psychotic features (PSYCH4)
    4. To describe the treatment for major depression and bipolar disorder (manic and depressive phases) for acute episodes and longer term maintenance. (PSYCH4)
    5. To summarise the signs and symptoms, differential diagnosis, course of illness, co-morbidity, prognosis and complications of mood disorders (PSYCH4, PSYCH4)
    6. Know when and how to use antimanic agents and know their side effects. (PSYCH4)
    7. To be able to screen for depressive symptoms (PSYCH4, PSYCH4)
    8. To be able to screen for suicidality and to identify and manage suicide risk in a general medical setting (PSYCH4, PSYCH4)
    9. To be able to screen for manic and hypomanic symptoms (PSYCH4, PSYCH4)
    10. To describe the treatment for major depression and bipolar disorder (manic and depressive phases) for acute episodes and longer term maintenance (PSYCH4, PSYCH4)
    11. Know when and how to use antidepressants and know their side effects (PSYCH4)
    12. Know when and how to use antimanic agents and know their side effects (PSYCH4)
    13. To understand the differences between depressive symptoms and depressive disorders and why the distinction is important (PSYCH4, PSYCH4)
    14. To understand the differences between sadness and grief associated with life events and depressive disorders (PSYCH4, PSYCH4)
  • Electroconvulsive Therapy
    1. Describe ECT as a treatment for major depression and bipolar disorder (manic and depressive phases) for acute episodes and longer term maintenance
  • Bi-polar Disorder
    1. To understand the classification of mood disorders and distinguish between unipolar depression and bipolar disorder (PSYCH4, PSYCH4)
    2. To be able to screen for manic and hypomanic symptoms (PSYCH4, PSYCH4)
    3. Review the management of bipolar disorder.
  • Pharmacological Management of Depression
    1. Know when and how to use antidepressants and know their side effects. (PSYCH4)
    2. Describe the pharmacology of tricyclic antidepressants
    3. Describe the pharmacology of monoamine oxidase inhibitors
    4. Describe the pharmacology of selective serotonin reuptake inhibitors.
    5. Know when and how to use antidepressants and know their side effects (PSYCH4)
• Delirium and Acute Confusion
  • General Outcomes for Delirium and Acute Confusion
    1. To understand the definition of delirium as a syndrome with many causes.
    2. To discuss the clinical features, differential diagnosis, evaluation and treatment of delirium.
    3. To be able to correctly describe the difference between delirium and dementia.
    4. To be able to correctly differentiate delirium from schizophrenia and depression.
  • Delirium and Confusion - Diagnosis and Management in A & E
  • Delirium in the Elderly
• Dementia
  • General Outcomes for Dementia
    1. To know the epidemiology, pathology and pathophysiology of Alzheimer’s disease
    2. To recognise the clinical features of Alzheimer's disease and distinguish other types of dementia
    3. To understand the principles and reasons for investigation of dementia and list investigations of dementia in the over 65 year old age group
    4. To appreciate different kinds of management of dementia and principles of community based care, to understand the principles behind advances in modern neurogenetics, molecular biology, and mechanisms of disease in examples such as Huntington's disease
  • Problems in old age
    1. Be able to elicit psychiatric symptoms and signs
    2. Be able to perform a cognitive assessment
    3. Know the community resources required for the optimum rehabilitation and management of dementia
    4. Know the general management of ANY psychiatric disorder over the first 24 hours of presentation
    5. Know the investigations used in psychiatry and be able to interpret their results
    6. Know when and how to use medications to treat dementia (including side effects)
    7. Know, as a non-specialist, how to treat a patient with a psychiatric illness.
    8. To appreciate different kinds of management of dementia and principles of community based care to understand the principles behind advances in modern neurogenetics and molecular biology and mechanisms of human disease in examples such as Huntingdon diseas
    9. To understand the epidemiology of the psychiatric index conditions
• Personality Disorders
  • General Outcomes for Personality Disorders
    1. Explain the basics of how personality traits and disorders are defined and classified. (PSYCH4)
    2. Outline the clinical features common to all personality disorders and the features which distinguish them. (PSYCH4)
    3. Know how to elicit psychiatric symptoms and signs of a patient with a personality disorder. (PSYCH4)
    4. Know the community resources required for the optimum rehabilitation and management of severe personality disorders. (PSYCH4)
    5. Appreciate moral difficulties posed by serious personality disorder and for the care of those so affected. (PSYCH4)
    6. To state the moral difficulties posed by serious personality disorder for the care of those so affected (PSYCH4)
• Psychiatric Emergencies
  • General Outcomes for Psychiatric Emergencies
    1. To have an overview of the major types of psychiatric emergencies (PSYCH4)
    2. Be able to assess a patient's potential danger to self or others. (PSYCH4)
    3. To know of risk factors and assessment of risk for psychiatric conditions (PSYCH4)
    4. Be able to assess suicide risk
    5. Be able to assess the seriousness of a suicide attempt
    6. Alcoholic Withdrawal Syndrome: Know the management of alcohol withdrawal, including delirium tremens (PSYCH4)
    7. Know the symptoms and management of Neuroleptic Malignant Syndrome (PSYCH4)
    8. Know the symptoms and management of Serotonin syndrome (PSYCH4)
    9. Know what to do in cases of patients with suicide risk or who pose a potential danger to self or others
    10. Know the symptoms and management of movement disorders including extra-pyramidal side effects; acute dystonia; akathisia and tardive dyskinesia (PSYCH4)
• Somatoform and Factitious Disorders
  • General Outcomes for Somatoform and Factitious Disorders
    1. To understand the principles behind the mind-body relationship
    2. To understand the main differences between the biomedical and biopsychosocial models of medicine.
    3. To understand how to assess a patient with medical, unexplained or chronic symptoms and disability and to be able to outline the principles of treating such a patient. (PSYCH4)
    4. Outline the clinical characteristics of somatization disorder, conversion disorder, body dysmorphic disorder and hypochondriasis.
    5. Outline the clinical characteristics of factitious disorder
    6. Be able to elicit psychiatric symptoms and signs
    7. To understand the two-way links between Medical diseases and Psychiatric disorders
• Eating Disorders
  • General Outcomes for Eating Disorders
    1. Be able to elicit psychiatric symptoms and signs of a patient with an eating disorder (PSYCH4)
    2. List the medical complications and indications for hospitalisation in patients with eating disorders
  • Anorexia Nervosa
    1. Summarise current knowledge of the aetiology, clinical features, epidemiology, course, co-morbidities, complications and treatment for anorexia nervosa
  • Bulimia Nervosa
    1. Summarise current knowledge of the aetiology, clinical features, epidemiology, course, co-morbid disorders, complications and treatment for bulimia nervosa
• Adjustment Disorders
  • General Outcomes for Adjustment Disorders
  • Bereavement
• Learning Disabilities
  • General Outcomes for Learning Disabilities
    1. Know the aetiology and prevalence of a learning disability (PSYCH4)
    2. Know the aetiology, prevalence and presentation of mental illness and behavioural problems in people with learning disability (PSYCH4)
    3. Know the definition of a learning disability (PSYCH4)
    4. Understand the assessment of psychiatric disorders in people with learning disabilities (PSYCH4)
    5. Understand the importance of community integration for people with learning difficulties (PSYCH4)
    6. Understand the stigma and prejudice associated with learning disabilities (PSYCH4)
    7. Understand the treatment of psychiatric disorders in people with learning disabilities (PSYCH4)
    8. Know the community resources required for the optimum rehabilitation and management of learning disabilities in children and adults (PSYCH4)
    9. Be able to communicate effectively with people with learning difficulties. (PSYCH4)
    10. Know and appreciate the importance of valuing skills of people with learning disability (PSYCH4)
    11. Know how to assess capacity to consent to treatment (PSYCH4)
• Substance Abuse and Dependence
  • General Outcomes for Substance Abuse and Dependence
    1. Substance Abuse and Dependence: Describe the impact of alcohol and drug misuse and dependence on the family and society (PSYCH4)
    2. Show a non-judgemental attitude to patients with substance misuse problems (PSYCH4)
    3. Substance Abuse and Dependence: Describe the psychological effects of the misuse of alcohol and other illicit drugs (PSYCH4)
    4. Substance Abuse and Dependence: Describe the range of individuals and services that are available to help the problem drinker and drug user and how to match the individual with the most appropriate service (PSYCH4)
    5. Substance Abuse and Dependence: Know the community resources required for the optimum rehabilitation and management of substance misuse and dependence (PSYCH4)
    6. Substance Abuse and Dependence: Know the investigations undertaken in cases of alcohol and substance misuse (PSYCH4)
    7. Substance Abuse and Dependence: List the social and behavioural associations of alcohol and drug misuse and dependence (PSYCH4)
    8. Substance Abuse and Dependence: Describe the pharmacological and metabolic effects of alcohol and other drugs of misuse. (PSYCH4)
  • Alcohol Abuse
    1. Alcohol Abuse: Describe the use of simple behavioural screening tests to recognise problematic alcohol use (PSYCH4)
    2. Alcohol Abuse: Describe the structural and functional effects of alcohol on the cardiovascular system including cardiomyopathy (PSYCH4)
    3. Alcohol Abuse: Describe the structural and functional effects on alcohol on the Gastrointestinal System, including Mallory-Weiss syndrome, gastritis, pancreatitis, alcoholic liver disease and the effect on nutrition (PSYCH4)
  • Alcoholic Withdrawal Syndrome
    1. Alcoholic Withdrawal Syndrome: Know the management of alcohol withdrawal, including delirium tremens (PSYCH4)
    2. Alcoholic Withdrawal Syndrome: Describe the management of the alcohol withdrawal syndrome and the Wernicke-Korsakoff syndrome (PSYCH4)
    3. Alcoholic Withdrawal Syndrome: Describe the structural and functional effects on alcohol on the neuropsychiatric system including the alcohol withdrawal syndrome, Wernicke-Korsakoff syndrome, polyneuropathy, cerebellar degeneration and myopathy (PSYCH4)
  • Opioid Dependence
    1. Describe the management of opioid dependence
• Suicide and Self Harm
  • General Outcomes for Suicide and Self Harm
    1. Be able to assess a patient's potential danger to self or others
    2. Know what to do in cases of patients with suicide risk or who pose a potential danger to self or others
    3. Be able to assess suicide risk
    4. Be able to assess the seriousness of a suicide attempt

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