Psych CASC / OSCE · General adult psychiatry — psychosis
Explain treatment-resistant schizophrenia and clozapine — CASC communication station
MRCPsych/FRANZCP-style communication station: explain TRS without stigma, outline clozapine benefits and monitoring, address fears, safety-net 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 community psychosis clinic. [4]
Candidate instructions. Explain what treatment-resistant schizophrenia means in plain language, why his previous trials count as adequate failures, why clozapine is being recommended, what blood tests and side-effects to expect (including constipation and early fever/chest pain warnings), and how you will monitor safety and symptoms. Check understanding and invite questions. The examiner plays the patient. [4]
References4ShowHide
- [1]Howes OD, McCutcheon R, Agid O, et al. Treatment-Resistant Schizophrenia: Treatment Response and Resistance in Psychosis (TRRIP) Working Group Consensus Guidelines on Diagnosis and Terminology Am J Psychiatry, 2017.PMID 27919182
- [2]Kane J, Honigfeld G, Singer J, et al. Clozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine Arch Gen Psychiatry, 1988.PMID 3046553
- [3]Meltzer HY, Alphs L, Green AI, et al. Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT) Arch Gen Psychiatry, 2003.PMID 12511175
- [4]Galletly C, Castle D, Dark F, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders Aust N Z J Psychiatry, 2016.PMID 27106681