Psych CASC / OSCE · General adult psychiatry — mood disorders
Explain treatment-resistant depression and next-step options — CASC communication station
MRCPsych/FRANZCP-style communication station: explain TRD without stigma, outline lithium augmentation with monitoring, address ECT fears, safety-net suicide risk, and check understanding.
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Target exams
Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the outpatient mood clinic. [3]
Candidate instructions. Explain what treatment-resistant depression means in plain language, why her previous trials count as adequate failures, why lithium augmentation is being recommended, what blood tests and side-effects to expect, when ECT might be discussed, and how you will monitor mood and safety. Check understanding and invite questions. The examiner plays the patient. [3]
References4ShowHide
- [1]Nierenberg AA, Fava M, Trivedi MH, et al. A comparison of lithium and T(3) augmentation following two failed medication treatments for depression: a STAR*D report Am J Psychiatry, 2006.PMID 16946176
- [2]UK ECT Review Group Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis Lancet, 2003.PMID 12642045
- [3]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
- [4]Rush AJ, Trivedi MH, Wisniewski SR, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report Am J Psychiatry, 2006.PMID 17074942