Prompt

A 35-year-old woman with stable depression on sertraline is distressed by low desire and poor arousal. She has read about 'Addyi' online and wants it today. She drinks wine most evenings. She feels ashamed and worries her partner will leave.

Station brief

Format. Communication station, approximately 7–10 minutes after reading. You are the psychiatry registrar in outpatient clinic.[4]

Candidate instructions. Explain that low desire/arousal with distress can be a treatable clinical problem (FSIAD/HSDD pathway), normalise using responsive-desire concepts, explore SSRI contribution, outline stepped care, and discuss flibanserin realistically including alcohol contraindication teaching. Negotiate a collaborative plan. Check understanding and address shame. The examiner plays the patient.[1][2][3][4]

Psychiatry Fellowship Pro

You have read the opening of this CASC / OSCE. The complete unit — every section and its primary-source references — is part of the Psychiatry Fellowship fellowship atlas.

References5Show ledger

[1]Basson R The female sexual response: a different model J Sex Marital Ther, 2000.PMID 10693116
[2]Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients J Clin Psychiatry, 2001.PMID 11229449
[3]Katz M, DeRogatis LR, Ackerman R, et al. Efficacy of flibanserin in women with hypoactive sexual desire disorder: results from the BEGONIA trial J Sex Med, 2013.PMID 23672269
[4]Clayton AH, Goldstein I, Kim NN, et al. The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women Mayo Clin Proc, 2018.PMID 29545008
[5]Segraves RT, Clayton A, Croft H, et al. Bupropion sustained release for the treatment of hypoactive sexual desire disorder in premenopausal women J Clin Psychopharmacol, 2004.PMID 15118489

Station brief

Format. Communication station, approximately 7–10 minutes after reading. You are the psychiatry registrar in outpatient clinic.[4]

Psychiatry Fellowship Pro

You have read the opening of this CASC / OSCE. The complete unit — every section and its primary-source references — is part of the Psychiatry Fellowship fellowship atlas.

References5Show ledger

[1]Basson R The female sexual response: a different model J Sex Marital Ther, 2000.PMID 10693116
[2]Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients J Clin Psychiatry, 2001.PMID 11229449
[3]Katz M, DeRogatis LR, Ackerman R, et al. Efficacy of flibanserin in women with hypoactive sexual desire disorder: results from the BEGONIA trial J Sex Med, 2013.PMID 23672269
[4]Clayton AH, Goldstein I, Kim NN, et al. The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women Mayo Clin Proc, 2018.PMID 29545008
[5]Segraves RT, Clayton A, Croft H, et al. Bupropion sustained release for the treatment of hypoactive sexual desire disorder in premenopausal women J Clin Psychopharmacol, 2004.PMID 15118489

Explain FSIAD care and negotiate SSRI options — CASC communication station

Station brief

Explain FSIAD care and negotiate SSRI options — CASC communication station

Station brief