Psych CASC / OSCE · Consultation-liaison psychiatry
Explaining MS depression, PBA, and treatment choices to a partner — CASC communication station
MRCPsych/FRANZCP-style station: explain MS depression and suicide risk, distinguish PBA from bipolar disorder, outline CBT/antidepressant and DM/Q options, and refuse unsafe unilateral DMT cessation.
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Format. Communication station, approximately 7–10 minutes after reading time. You are the psychiatry registrar. Neurology remains involved. You meet the partner first (with patient consent as per local practice).[1]
Candidate instructions. Explain that depression in MS is common, treatable, and linked to suicide risk — not something to ignore as "understandable." Distinguish pseudobulbar affect (brief involuntary crying) from bipolar disorder. Outline talking therapies (including telephone CBT) and antidepressants. Explain that stopping interferon today without neurology is unsafe. Agree a collaborative plan. Avoid inventing legal section numbers.[2][4][5]
References5ShowHide
- [1]Goldman Consensus Group The Goldman Consensus statement on depression in multiple sclerosis Mult Scler, 2005.PMID 15957516
- [2]Minden SL, Feinstein A, Kalb RC, et al. Evidence-based guideline: assessment and management of psychiatric disorders in individuals with MS Neurology, 2014.PMID 24376275
- [3]Pioro EP, Brooks BR, Cummings J, et al. Dextromethorphan plus ultra low-dose quinidine reduces pseudobulbar affect Ann Neurol, 2010.PMID 20839238
- [4]Mohr DC, Hart SL, Julian L, et al. Telephone-administered psychotherapy for depression Arch Gen Psychiatry, 2005.PMID 16143732
- [5]Feinstein A, Pavisian B Multiple sclerosis and suicide Mult Scler, 2017.PMID 28327056