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Clinical Psychiatry

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Clinical Psychiatry Thursdays 9:30-12:00 (most days) Exams Students will need their laptop in class on exam days to login and complete their online exam. Course Overview Outline Objectives Project #1 Project #2 Faculty Textbook Evaluation Grading Bonus Attendance

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clinical psychiatry
Clinical Psychiatry

Thursdays

9:30-12:00 (most days)

Exams

Students will need their laptop in class on exam days to login and complete their online exam.

course overview
Course Overview

Outline

Objectives

Project #1

Project #2

Faculty

Textbook

EvaluationGradingBonus

Attendance

models of disease interviewing
Models of Disease & Interviewing
  • Biological system
  • Psychological System
  • Social system
meaning of being sick
Meaning of Being Sick
  • Illness Behavior
  • Sick Role
  • Product of the Medical System
  • Secondary Gain
doctor patient models
Doctor-Patient Models
  • Active-passive
  • Teacher-student
  • Mutual participation model
  • Friendship model
effective interviews
Effective Interviews
  • Assessment of Problem
  • Develop and maintain therapeutic relationship
  • Communicate Information
  • Implement Treatment Plan
interviewing techniques
Interviewing Techniques
  • Clinical Interviewing
    • Develop Relationship/Problem Identification
  • Biopsychosocial History
    • Decision Tree/History and data gathering
  • Rapport
    • Diagnoses and Feedback
  • Techniques
    • Prognosis & Plan
  • Difficult Patients
    • Differential Diagnosis
      • Chapter 1
clinical examination
Clinical Examination
  • Mental Status Examination

Appearance; Attitude toward Examiner; Speech Characteristics; Psychomotor; Mood; Affect; Perception; Thought Process; Thought Content; Sensorium & Cognition; Concentration & Attention; Reading and Writing; Visuospatial Ability; Abstract Thought; Information & Intelligence; Judgment & Insight

      • Chapter 1
assessment
Assessment
  • Psychiatric Disorder
    • RoS
    • Physical Exam
      • Nature of the Complaint
      • Adverse Reactions
      • Medical Referrals from Psychiatrists
laboratory tests
Laboratory Tests
  • Neuroendocrine
    • Thyroid; Cortisol Suppression; Kidney and Liver function
  • Blood Tests
    • STDs
  • Psychotropic Medications
    • Lithium but not most
  • Provocation of Panic Attacks
    • Sodium Lactate (72%)
  • Lumbar Puncture
    • Cognitive Changes due to CNS Infection
  • Substance Abuse
    • Random or purposeful
typical signs symptoms in psychiatric illness
Typical Signs & Symptoms in Psychiatric Illness
  • Consciousness
  • Emotion
  • Motor behavior
  • Thinking
  • Speech
  • Perception
  • Memory
  • Intelligence
      • Chapter 3
classification systems
Classification Systems
  • ICD-10
  • DSM-IV
    • Axis I - Clinical Disorders
    • Axis II - Personality Disorders
    • Axis III - General Medical Conditions
    • Axis IV - Psychosocial Stressors
    • Axis V - GAF
      • Chapter 5
global assessment functioning
Global Assessment Functioning
  • Most commonly used with DSMIV (Axis V)
  • Clinician’s Judgment of patient’s overall level of functioning (100-0)
mental health stats
Mental Health Stats
  • 30% of population has a diagnosable mental disorder (2008 Surgeon General)
  • $300 Billion annual cost of untreated mental illness. (NIMH 2006)
  • $30 Billion a year in absenteeism and poor work performance (MIT 2006)
  • No federal law that requires employers to provide adequate health insurance for mental health (2001)
  • 2002 Labor HHS Education appropriations bill called for parity. Passed in 2008 but has not implemented for the most part.
  • 2009 – US Citizens continue to experience decrease in health and mental health coverage
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