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Psych CASC / OSCEGeneral adult psychiatry — anxiety disorders

Psych CASC / OSCE · General adult psychiatry — anxiety disorders

Explain panic disorder and treatment plan — CASC communication station

MRCPsych/FRANZCP-style communication station: explain panic false-alarm model, outline sertraline start with early activation warning, describe CBT with interoceptive exposure in plain language, and correct chronic benzodiazepine expectations.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
A 27-year-old teacher with new panic disorder and mild agoraphobia wants an explanation of what is happening to her body, whether she is 'going crazy' or having heart attacks, why CBT and an SSRI are suggested, and whether she will need diazepam forever.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the outpatient clinic. [3]

Candidate instructions. Explain the diagnosis of panic disorder (and mild agoraphobia if raised), the false-alarm model in plain language, the rationale for CBT with exposure, the plan for sertraline including early side-effects and delayed benefit, and why long-term diazepam is not the goal. Check understanding and invite questions. The examiner plays the patient. [3]

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References4ShowHide
  1. [1]Clark DM, Salkovskis PM, Hackmann A, et al. A comparison of cognitive therapy, applied relaxation and imipramine in the treatment of panic disorder Br J Psychiatry, 1994.PMID 7952982
  2. [2]Pollack MH, Otto MW, Worthington JJ, et al. Sertraline in the treatment of panic disorder: a flexible-dose multicenter trial Arch Gen Psychiatry, 1998.PMID 9819070
  3. [3]Bandelow B, Michaelis S, Wedekind D Treatment of anxiety disorders Dialogues Clin Neurosci, 2017.PMID 28867934
  4. [4]Roy-Byrne PP, Craske MG, Stein MB, et al. A randomized effectiveness trial of cognitive-behavioral therapy and medication for primary care panic disorder Arch Gen Psychiatry, 2005.PMID 15753242
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