Psych CASC / OSCE · General adult psychiatry — bipolar and related disorders
Explain acute mania treatment, lithium, and why the antidepressant stopped — CASC communication station
MRCPsych/FRANZCP-style communication station: plain-language explanation of mania vs hypomania, polarity-safe treatment, lithium monitoring/toxicity warnings, RT/seclusion rationale, and relapse prevention.
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Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar on the inpatient unit.[1]
Candidate instructions. Explain what a manic episode is (versus a milder high). Explain why sertraline was stopped. Outline lithium and olanzapine benefits, common side-effects, and blood tests. Explain why seclusion may have been used as a last-resort safety step. Outline going-home prevention (sleep, early-warning signs, follow-up). Check understanding and invite questions. The examiner plays the partner.[1][2][4]
References6ShowHide
- [1]Malhi GS, Bell E, Bassett D, et al. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders Aust N Z J Psychiatry, 2021.PMID 33353391
- [2]Sachs GS, Nierenberg AA, Calabrese JR, et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression N Engl J Med, 2007.PMID 17392295
- [3]McKnight RF, Adida M, Budge K, et al. Lithium toxicity profile: a systematic review and meta-analysis Lancet, 2012.PMID 22265699
- [4]Patel MX, Sethi FN, Barnes TR, et al. Joint BAP NAPICU evidence-based consensus guidelines for the clinical management of acute disturbance: De-escalation and rapid tranquillisation J Psychopharmacol, 2018.PMID 29882463
- [5]Geddes JR, Goodwin GM, Rendell J, et al. Lithium plus valproate combination therapy versus monotherapy for relapse prevention in bipolar I disorder (BALANCE): a randomised open-label trial Lancet, 2010.PMID 20092882
- [6]Cipriani A, Hawton K, Stockton S, et al. Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis BMJ, 2013.PMID 23814104