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Psych CASC / OSCEOld age psychiatry — anxiety disorders

Psych CASC / OSCE · Old age psychiatry — anxiety disorders

Explain late-life GAD treatment and benzodiazepine taper to patient and daughter — CASC communication station

MRCPsych/FRANZCP-style communication station: late-life GAD, CBT/SSRI plan, Beers-informed benzodiazepine taper, hyponatraemia safety-netting, suicide safety.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
A 73-year-old woman with late-life generalised anxiety disorder and her adult daughter want a plain-language explanation of the diagnosis, why CBT and an SSRI are recommended, why long-term diazepam should be tapered, sodium monitoring, and when to seek help for low mood or suicidal thoughts.

Station brief

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

Candidate instructions. Explain late-life generalised anxiety disorder in plain language; outline CBT and SSRI treatment; explain why long-term benzodiazepines are risky in older adults and how a slow taper works; mention blood sodium checks; safety-net for worsening mood or suicidal thoughts; check understanding. Examiner plays the patient; a second role-player may be the daughter. [2][3]

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References6ShowHide
  1. [1]Wolitzky-Taylor KB, Castriotta N, Lenze EJ, Stanley MA, Craske MG Anxiety disorders in older adults: a comprehensive review Depress Anxiety, 2010.PMID 20099273
  2. [2]Stanley MA, Wilson NL, Novy DM, et al. Cognitive behavior therapy for generalized anxiety disorder among older adults in primary care: a randomized clinical trial JAMA, 2009.PMID 19351943
  3. [3]Lenze EJ, Rollman BL, Shear MK, et al. Escitalopram for older adults with generalized anxiety disorder: a randomized controlled trial JAMA, 2009.PMID 19155456
  4. [4]Fabian TJ, Amico JA, Kroboth PD, et al. Paroxetine-induced hyponatremia in older adults: a 12-week prospective study Arch Intern Med, 2004.PMID 14769630
  5. [5]By the 2023 American Geriatrics Society Beers Criteria Update Expert Panel American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults J Am Geriatr Soc, 2023.PMID 37139824
  6. [6]Conwell Y, Van Orden K, Caine ED Suicide in older adults Psychiatr Clin North Am, 2011.PMID 21536168
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