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 l.jpg
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 l.jpg
Course Overview

Outline

Objectives

Project #1

Project #2

Faculty

Textbook

EvaluationGradingBonus

Attendance


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Models of Disease & Interviewing

  • Biological system

  • Psychological System

  • Social system


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Meaning of Being Sick

  • Illness Behavior

  • Sick Role

  • Product of the Medical System

  • Secondary Gain


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Doctor-Patient Models

  • Active-passive

  • Teacher-student

  • Mutual participation model

  • Friendship model


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Effective Interviews

  • Assessment of Problem

  • Develop and maintain therapeutic relationship

  • Communicate Information

  • Implement Treatment Plan


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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


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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


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Assessment

  • Psychiatric Disorder

    • RoS

    • Physical Exam

      • Nature of the Complaint

      • Adverse Reactions

      • Medical Referrals from Psychiatrists


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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


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Typical Signs & Symptoms in Psychiatric Illness

  • Consciousness

  • Emotion

  • Motor behavior

  • Thinking

  • Speech

  • Perception

  • Memory

  • Intelligence

    • Chapter 3


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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


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Global Assessment Functioning

  • Most commonly used with DSMIV (Axis V)

  • Clinician’s Judgment of patient’s overall level of functioning (100-0)


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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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