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Psych CASC / OSCEGeneral adult psychiatry — somatic symptom and related

Psych CASC / OSCE · General adult psychiatry — somatic symptom and related

Explain illness anxiety, CBT and collaborative care — CASC communication station

MRCPsych/FRANZCP-style communication station: explain IAD, CBT health anxiety, SSRI, anti-collusion with testing, family accommodation, safety-netting.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
A 40-year-old woman newly diagnosed with illness anxiety disorder (care-seeking) after repeated normal breast imaging for fear of breast cancer wants a plain-language explanation of the diagnosis, why specialised CBT with stopping checking and internet searching will help, how an SSRI might help, why another MRI 'for peace of mind' is not planned tonight, how her partner should stop endless reassurance, and what to do if mood or suicidal thoughts worsen.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the outpatient clinic. [2]

Candidate instructions. Explain illness anxiety disorder in plain language, outline specialised CBT with exposure and response prevention elements, discuss a possible SSRI (e.g. fluoxetine or sertraline) with delayed full benefit, explain why further imaging without new clinical change is not the treatment, address partner reassurance, and check understanding. The examiner plays the patient. [1][4]

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References5ShowHide
  1. [1]Barsky AJ, Ahern DK Cognitive behavior therapy for hypochondriasis: a randomized controlled trial JAMA, 2004.PMID 15039413
  2. [2]Tyrer P, Cooper S, Salkovskis P, et al. Clinical and cost-effectiveness of cognitive behaviour therapy for health anxiety in medical patients: a multicentre randomised controlled trial Lancet, 2014.PMID 24139977
  3. [3]Fallon BA, Ahern DK, Pavlicova M, et al. A Randomized Controlled Trial of Medication and Cognitive-Behavioral Therapy for Hypochondriasis Am J Psychiatry, 2017.PMID 28659038
  4. [4]Warwick HM, Salkovskis PM Hypochondriasis Behav Res Ther, 1990.PMID 2183757
  5. [5]Mataix-Cols D, Isomura K, Sidorchuk A, et al. All-Cause and Cause-Specific Mortality Among Individuals With Hypochondriasis JAMA Psychiatry, 2024.PMID 38091000
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