Paeds Cases · mental-behavioural-and-psychosomatic
Explain a first episode of psychosis to a young person and family — OSCE
OSCE communication station: explaining a first episode of psychosis as a treatable medical illness, the duration-of-untreated-psychosis rationale for prompt specialist referral, first-line antipsychotic treatment and metabolic monitoring, and cannabis as a modifiable risk factor, framed without blame.
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Explain that a first episode of psychosis is a real and treatable medical illness, not a character flaw or a parenting failure; describe why prompt specialist referral matters through the duration-of-untreated-psychosis idea in plain terms; outline first-line antipsychotic treatment and what the medication will and will not do; address cannabis as a modifiable risk factor without blame; describe the metabolic monitoring plan; check understanding; and agree a shared written plan. The examiner plays a parent. [2] [4]
References5ShowHide
- [1]Sikich L, Frazier JA, McClellan J, Findling RL, Vitiello B, et al. Double-blind comparison of first- and second-generation antipsychotics in early-onset schizophrenia and schizo-affective disorder: findings from the Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS) study. American Journal of Psychiatry, 2008.PMID 18794207
- [2]McClellan J, Stock S Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. Journal of the American Academy of Child and Adolescent Psychiatry, 2013.PMID 23972700
- [4]Penttilä M, Jääskeläinen E, Hirvonen N, Isohanni M, Miettunen J Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis. British Journal of Psychiatry, 2014.PMID 25252316
- [5]Moore TH, Zammit S, Lingford-Hughes A, Barnes TR, Jones PB, et al. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet, 2007.PMID 17662880
- [6]Arseneault L, Cannon M, Poulton R, Murray R, Caspi A, Moffitt TE Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ, 2002.PMID 12446537