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Psych CASC / OSCEGeneral adult psychiatry — bipolar and related disorders

Psych CASC / OSCE · General adult psychiatry — bipolar and related disorders

Explain bipolar I diagnosis and lithium plan — CASC communication station

MRCPsych/FRANZCP-style communication station: explain bipolar I after first mania, lithium initiation and monitoring, BALANCE maintenance rationale, sleep and early-warning signs, and antidepressant caution.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
A 29-year-old man recovering from a first manic episode wants an explanation of bipolar I, why lithium is recommended for maintenance, side-effects and blood tests, suicide risk framing, and why an antidepressant alone is not the plan if he becomes depressed later. His partner is present with consent.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar on the inpatient ward preparing for discharge planning. [4]

Candidate instructions. Explain bipolar I disorder after a first manic episode, the rationale for lithium maintenance, baseline and ongoing blood tests, common side-effects and toxicity warning signs, why sleep and early-warning signs matter, and why antidepressant monotherapy is not appropriate if depression returns. Check understanding and invite questions from patient and partner. [4]

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References4ShowHide
  1. [1]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
  2. [2]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
  3. [3]McKnight RF, Adida M, Budge K, et al. Lithium toxicity profile: a systematic review and meta-analysis Lancet, 2012.PMID 22265699
  4. [4]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
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