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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 II, stopping the antidepressant, and starting quetiapine plus planned lamotrigine — CASC communication station

MRCPsych/FRANZCP-style communication station: plain-language bipolar II explanation, hypomania vs mania, antidepressant switch risk with STEP-BD framing, quetiapine metabolic counselling, lamotrigine slow titration and rash safety.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
Partner of a 29-year-old woman wants to understand why the GP's 'depression tablet' was stopped, what bipolar II and hypomania mean, and what quetiapine and future lamotrigine involve.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in outpatient clinic. [3]

Candidate instructions. Explain bipolar II and hypomania in plain language. Explain why the antidepressant was stopped. Outline the plan for quetiapine now and lamotrigine later, including common side-effects, blood tests or monitoring, and rash safety. Check understanding and invite questions. The examiner plays the partner. [1][2][3]

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References4ShowHide
  1. [1]Sachs GS, Nierenberg AA, Calabrese JR, et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression N Engl J Med, 2007.PMID 17392295
  2. [2]Calabrese JR, Keck PE Jr, Macfadden W, et al. A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression Am J Psychiatry, 2005.PMID 15994719
  3. [3]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
  4. [4]Goodwin GM, Bowden CL, Calabrese JR, et al. A pooled analysis of 2 placebo-controlled 18-month trials of lamotrigine and lithium maintenance in bipolar I disorder J Clin Psychiatry, 2004.PMID 15096085
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