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.
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Target exams
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]
References5ShowHide
- [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]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]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]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]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