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Psych CASC / OSCEGeneral adult psychiatry — substance/medication-induced psychosis

Psych CASC / OSCE · General adult psychiatry — substance/medication-induced psychosis

Explain substance-induced psychosis and follow-up to parents — CASC communication station

MRCPsych/FRANZCP-style communication station: explain SIP timeline diagnosis, acute treatment, conversion risk without fatalism, dual follow-up, and non-moralising cannabis counselling.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
Parents of a 20-year-old with first cannabis-associated psychosis want plain-language explanation of diagnosis, why medication is offered, conversion risk, cannabis advice, and whether this means lifelong schizophrenia.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar on the early intervention / acute ward. [1]

Candidate instructions. Explain the working diagnosis of substance-induced (cannabis-associated) psychosis to the parents, outline medical checks and why an antipsychotic may be used, discuss the importance of cannabis cessation, address the risk of later primary psychotic illness honestly without catastrophic fatalism, and describe the follow-up plan. Check understanding. The examiner plays both parents. [1]

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References3ShowHide
  1. [1]Starzer MSK, Nordentoft M, Hjorthøj C Rates and Predictors of Conversion to Schizophrenia or Bipolar Disorder Following Substance-Induced Psychosis Am J Psychiatry, 2018.PMID 29179576
  2. [2]Murrie B, Lappin J, Large M, et al. Transition of Substance-Induced, Brief, and Atypical Psychoses to Schizophrenia: A Systematic Review and Meta-analysis Schizophr Bull, 2020.PMID 31618428
  3. [3]Schoeler T, Petros N, Di Forti M, et al. Effects of continuation, frequency, and type of cannabis use on relapse in the first 2 years after onset of psychosis: an observational study Lancet Psychiatry, 2016.PMID 27567467
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