Psych CASC / OSCE · General adult psychiatry — perinatal
Explain postpartum psychosis, admission and treatment to a distressed partner — CASC communication station
MRCPsych/FRANZCP-style communication station: explain PPP as treatable emergency, dual risk and MBU logic, sequential treatment including lithium/ECT principles, safeguarding honesty, and next-pregnancy prevention — without false reassurance or stigma.
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Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar after assessing the mother. [1]
Candidate instructions. Explain postpartum psychosis as a medical-psychiatric emergency that is highly treatable; outline why admission (ideally mother-baby unit if available and safe) is needed; describe dual risk planning for mother and infant honestly; explain sequential treatment principles (sleep, antipsychotic, lithium with monitoring, ECT if required) and lactation trade-offs; address child-protection fears without promising absolute secrecy if acute risk; discuss high recurrence risk and prevention for a future pregnancy. Check understanding. The examiner plays the partner. [2][5][3]
References6ShowHide
- [1]Bergink V, Rasgon N, Wisner KL Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood Am J Psychiatry, 2016.PMID 27609245
- [2]Bergink V, Burgerhout KM, Koorengevel KM, et al. Treatment of psychosis and mania in the postpartum period Am J Psychiatry, 2015.PMID 25640930
- [3]Wesseloo R, Kamperman AM, Munk-Olsen T, et al. Risk of Postpartum Relapse in Bipolar Disorder and Postpartum Psychosis: A Systematic Review and Meta-Analysis Am J Psychiatry, 2016.PMID 26514657
- [4]Bergink V, Bouvy PF, Vervoort JS, et al. Prevention of postpartum psychosis and mania in women at high risk Am J Psychiatry, 2012.PMID 22407083
- [5]Galbally M, Sved-Williams A, Kristianopulos D, et al. Comparison of public mother-baby psychiatric units in Australia: similarities, strengths and recommendations Australas Psychiatry, 2019.PMID 30407072
- [6]Malhi GS, Bell E, Bassett D, et al. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders Aust N Z J Psychiatry, 2021.PMID 33353391