Psych CASC / OSCE · Consultation-liaison psychiatry
Explaining post-ACS depression and the care plan to a family — CASC communication station
MRCPsych/FRANZCP-style station: explain post-ACS depression, SADHART/ENRICHD literacy in plain language, beta-blocker myth, safety of sertraline, capacity caution, and rehab plan.
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Station brief
Format. Communication station, approximately 7–10 minutes after reading time. You are the psychiatry registrar on the cardiology step-down unit. The patient is not in the room for this conversation.[1]
Candidate instructions. Explain post-ACS depression in plain language, outline why sertraline and rehab psychology are used, address reinfarction-prevention expectations honestly, correct the beta-blocker myth gently, manage house-transfer capacity timing, and address heart-failure concerns without false hopelessness.[1][3][4]
References6ShowHide
- [1]Lichtman JH, Bigger JT Jr, Blumenthal JA, et al. Depression and coronary heart disease: recommendations for screening, referral, and treatment Circulation, 2008.PMID 18824640
- [2]Lichtman JH, Froelicher ES, Blumenthal JA, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome Circulation, 2014.PMID 24566200
- [3]Glassman AH, O'Connor CM, Califf RM, et al. Sertraline treatment of major depression in patients with acute MI or unstable angina (SADHART) JAMA, 2002.PMID 12169073
- [4]Berkman LF, Blumenthal J, Burg M, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction (ENRICHD) JAMA, 2003.PMID 12813116
- [5]O'Connor CM, Jiang W, Kuchibhatla M, et al. Safety and efficacy of sertraline for depression in patients with heart failure (SADHART-CHF) J Am Coll Cardiol, 2010.PMID 20723799
- [6]Frasure-Smith N, Lespérance F, Talajic M Depression following myocardial infarction. Impact on 6-month survival JAMA, 1993.PMID 8411525