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Psych CASC / OSCEGeneral adult psychiatry — clinical high risk / attenuated psychosis

Psych CASC / OSCE · General adult psychiatry — clinical high risk / attenuated psychosis

Explain clinical high risk to parents — CASC communication station

MRCPsych/FRANZCP-style communication station: explain UHR/CHR without fatalism, outline stepped care (CBT, comorbidity, monitoring), antipsychotics not first-line, omega-3 equipoise, cannabis advice, and escalation if frank psychosis appears.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
Parents of a 17-year-old with attenuated psychotic symptoms want a plain-language explanation of whether this is schizophrenia, conversion risk, treatment options, cannabis, medication, and school.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the youth early-psychosis clinic. [1]

Candidate instructions. Explain the working formulation of clinical high risk / attenuated psychotic symptoms to the parents. Cover what it is and is not, realistic conversion expectations, planned care (psychological therapies, treating anxiety/depression, cannabis, monitoring), when medication might be considered, and what happens if symptoms become frank. Check understanding and safety-net. The examiner plays both parents. [2][3]

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References5ShowHide
  1. [1]Yung AR, Yuen HP, McGorry PD, et al. Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States Aust N Z J Psychiatry, 2005.PMID 16343296
  2. [2]Salazar de Pablo G, Radua J, Pereira J, et al. Probability of Transition to Psychosis in Individuals at Clinical High Risk: An Updated Meta-analysis JAMA Psychiatry, 2021.PMID 34259821
  3. [3]van der Gaag M, Smit F, Bechdolf A, et al. Preventing a first episode of psychosis: meta-analysis of randomized controlled prevention trials of 12 month and longer-term follow-ups Schizophr Res, 2013.PMID 23870806
  4. [4]McGorry PD, Nelson B, Markulev C, et al. Effect of ω-3 Polyunsaturated Fatty Acids in Young People at Ultrahigh Risk for Psychotic Disorders: The NEURAPRO Randomized Clinical Trial JAMA Psychiatry, 2017.PMID 27893018
  5. [5]Galletly C, Castle D, Dark F, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders Aust N Z J Psychiatry, 2016.PMID 27106681
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