KE3 Nature of the Subject: Psychiatry Portal

1. KE3 Nature of the Subject: Psychiatry Portal Don’t tell me – Show me! Dr Paul Hopper, Nicholas Martin, Dr Jennifer Rowden 24th March 2011

2. Introduction Forum Virtual Case Compendium Any Questions? KE3 Nature of the Subject Don’t tell me – Show me!

3. The Forum Don’t tell me – Show me!

4. What might be more difficult about caringfor a loved one with dementia at 47 rather than 77? http://topics.nytimes.com/top/news/health/series/the_vanishing_mind/index.html Don’t tell me – Show me!

5. YARUMAL, Colombia -- Tucked away on a steep street in this rough-hewn mountain town, an old woman found herself diapering her middle-age children. It is Alzheimer's disease, and at 82, Mrs. Cuartas, her gray raisin of a face grave, takes care of three of her afflicted children..……. Large families, and intermarriage, have accelerated the spread. Mrs. Cuartas's fourth debilitated child, in Medellín, Carlos Alberto Villegas, …. is now often fed by baby bottle, married a distant cousin…….. With Alzheimer's in both parents' families, Mr. Villegas's three children could face extraordinary risk. One, Natalia, 22, asks: ''How long have I got, till I'm 35? There's no way out.''

6. “To watch your loved ones suffer and decline with a disease that you have a high chance of also developing sounds terrifying.” Ruth Hillier “If I were in the position of someone of this age caring for someone of a similar age, I would feel afraid of what would happen and of coping alone.“ Lizzie Casselden “The strong genetic link in early onset Alzheimer's may also be difficult to come to terms with psychologically…this could potentially lead to other mental illness in these groups such as anxiety, depression and a potential suicide risk.” Grace O'Doherty “There can also be feeling of anger and grief as both the carer and patient may feel that their future has been taken away from them.” Daniel Pierce White “Knowing that you, the carer, may soon develop the disease as well must only add to your troubles and stresses.” Hannah Goodchild “Someone at 47 may have a young family who would be helping to care for their parent - a role reversal…they probably wouldn't be able to appreciate their children growing up/participate in day to day activities.” Ava Nepute “…little difference between caring for our elders regardless of their age…because they all have a part to play, and again I emphasize their role as morale foundations; the 'loss' of which will affect the family unit equally at 47 and 77.” Steven Tan

7. Virtual Cases Don’t tell me – Show me!

8. Virtual Cases • Longitudinal nature of most psychiatric cases • Short clinical attachments • Reduced access to teaching matierial • Engaging, entertaining and empathy inducing • Flexible learning • Delirium, Depression, Schizophrenia, Dementia, Substance Misuse in development Don’t tell me – Show me!

9. Virtual Cases - Dementia Don’t tell me – Show me!

10. Core Curriculum Topics Don’t tell me – Show me!

11. The Compendium “Vocabulary” of psychiatry Multidimensional and contextual Mental State based Don’t tell me – Show me!

12. Compendium Flight of Ideas – Don’t tell me – Show me!

13. Flight of Ideas What do you understand by flight of ideas? Don’t tell me – Show me!

14. Don’t tell me – Show me!

15. Textbook definition In acceleration of thinking, associations are still formed normally but at a grossly accelerated speed. The goal is not maintained for long and the intervention of new thoughts produces “flight of ideas”. New Oxford Textbook of Psychiatry 2009 Gelder et al OR A nearly continuous flow or accelerated speech with abrupt changes from topic to topic, usually based on understandable associations, distracting stimuli, or plays on words. University of Michigan Medical Center.

16. Flight of Ideas Don’t tell me – Show me!

17. Don’t tell me – Show me! ANY QUESTIONS?