Psych CASC / OSCE · Intellectual disability psychiatry
Explain dual diagnosis and psychotropic review to carers — CASC communication station
MRCPsych/FRANZCP-style communication station: explain diagnostic overshadowing without jargon overload, modified presentation, medical checks, DC-LD-adapted thinking in plain language, and evidence-based psychotropic caution with collaborative review.
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Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the intellectual disability clinic. [1]
Candidate instructions. Explain to the carers that new self-injury may reflect mental or physical illness rather than "just intellectual disability", outline the assessment plan, discuss why long-term risperidone needs review, and agree a collaborative plan. Avoid jargon; check understanding; do not invent legal section numbers. [2]
References5ShowHide
- [1]Cooper SA, Smiley E, Morrison J, Williamson A, Allan L Mental ill-health in adults with intellectual disabilities: prevalence and associated factors Br J Psychiatry, 2007.PMID 17197653
- [2]Ali A, Hassiotis A Illness in people with intellectual disabilities BMJ, 2008.PMID 18340045
- [3]Tyrer P, Oliver-Africano PC, Ahmed Z, et al. Risperidone, haloperidol, and placebo in the treatment of aggressive challenging behaviour in patients with intellectual disability: a randomised controlled trial Lancet, 2008.PMID 18177776
- [4]Sheehan R, Hassiotis A, Walters K, Osborn D, Strydom A, Horsfall L Mental illness, challenging behaviour, and psychotropic drug prescribing in people with intellectual disability: UK population based cohort study BMJ, 2015.PMID 26330451
- [5]Deb S, Kwok H, Bertelli M, et al. International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities World Psychiatry, 2009.PMID 19812757