Psych CASC / OSCE · Consultation-liaison psychiatry
Explaining personality change and treatment after TBI to a partner — CASC communication station
MRCPsych/FRANZCP-style communication station: explain personality change and depression after TBI, the limits of drug treatment, and the role of rehabilitation and family.
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
A 42-year-old man is 3 months after moderate TBI with frontal contusions. He is less inhibited, snaps at staff, and has been started on sertraline for depression. His partner is distressed: 'They broke his personality. Give him something strong to knock him out. Will he ever be himself again?'
Candidate brief
Format. Communication station. You are the psychiatry registrar on the brain-injury rehabilitation unit. The patient is not in the room.
Candidate instructions. Explain the changes after brain injury in plain language, explain the depression treatment, respond to the request for strong sedation, describe the non-drug plan, and give an honest outlook.
References5ShowHide
- [1]Howlett JR, Nelson LD, Stein MB Mental Health Consequences of Traumatic Brain Injury. Biological psychiatry, 2022.PMID 34893317
- [2]Plantier D, Luauté J, SOFMER group Drugs for behavior disorders after traumatic brain injury: Systematic review and expert consensus leading to French recommendations for good practice. Annals of physical and rehabilitation medicine, 2016.PMID 26797170
- [3]Fann JR, Bombardier CH, Temkin N, et al. Sertraline for Major Depression During the Year Following Traumatic Brain Injury: A Randomized Controlled Trial. The Journal of head trauma rehabilitation, 2017.PMID 28520672
- [4]Rao V, Koliatsos V, Ahmed F, et al. Neuropsychiatric disturbances associated with traumatic brain injury: a practical approach to evaluation and management. Seminars in neurology, 2015.PMID 25714869
- [5]Jorge RE, Robinson RG, Moser D, et al. Major depression following traumatic brain injury. Archives of general psychiatry, 2004.PMID 14706943