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