Psych CASC / OSCE · General adult psychiatry — OCRD
Explain BDD, CBT-BDD and SSRI to a patient — CASC communication station
MRCPsych/FRANZCP-style communication station: explain BDD, ERP-style CBT, SSRI timeline, anti-surgery advice, family accommodation, and safety-netting for mood/suicidality.
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
A 27-year-old woman newly diagnosed with BDD wants a plain-language explanation of the diagnosis, why specialised CBT with exposure and stopping checking will help, how an SSRI such as fluoxetine might help at higher doses over months, why rhinoplasty is not recommended as treatment, and what her partner should stop doing (endless reassurance and mirror checks).
Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the outpatient clinic. [4]
Candidate instructions. Explain BDD in plain language, outline specialised CBT with exposure and response prevention elements, discuss a possible SSRI (e.g. fluoxetine) with delayed benefit and higher-dose rationale, advise against surgery as a cure, address partner reassurance/mirror collusion, and check understanding. The examiner plays the patient. [4][5]
References5ShowHide
- [1]Phillips KA, Albertini RS, Rasmussen SA A randomized placebo-controlled trial of fluoxetine in body dysmorphic disorder Arch Gen Psychiatry, 2002.PMID 11926939
- [2]Wilhelm S, Phillips KA, Didie E, et al. Modular cognitive-behavioral therapy for body dysmorphic disorder: a randomized controlled trial Behav Ther, 2014.PMID 24680228
- [3]Crerand CE, Menard W, Phillips KA Surgical and minimally invasive cosmetic procedures among persons with body dysmorphic disorder Ann Plast Surg, 2010.PMID 20467296
- [4]Castle D, Beilharz F, Phillips KA, et al. Body dysmorphic disorder: a treatment synthesis and consensus on behalf of the International College of Obsessive-Compulsive Spectrum Disorders Int Clin Psychopharmacol, 2021.PMID 33230025
- [5]Phillips KA, Kelly MM Body Dysmorphic Disorder: Clinical Overview and Relationship to Obsessive-Compulsive Disorder Focus (Am Psychiatr Publ), 2021.PMID 35747292