ADULT MENTAL HEALTH PART B

Transcription

1 Wessex Core Psychiatry Course Specialty Module Handbook ADULT MENTAL HEALTH PART B Health Education England Wessex School of Psychiatry

2 Specialty Module: Adult Mental Health Module Handbook Contents 1. Introduction 2. Aims of the Module 3. Summary Timetable 4. Learning Objectives for each topic 5. Detailed timetable 6. Reading List 7. Contacts 8. Library and IT facilities 2

3 Core Psychiatry Course 2017 / 2018 Specialty Module: Adult Mental Health Module Handbook Introduction This handbook should be read in conjunction with various other handbooks available on the course website (Facilitator Handbook, Educational Supervisor Handbook and Course Handbook). The Core Psychiatry course has been designed to address the changing needs of trainees in the light of recent changes in psychiatry training and the Royal College of Psychiatry curriculum (June 2017). This handbook will aim to address issues relevant to adult mental health. Course information and copies of the handbooks are available to download from the Postgraduate website: A Competency Based Curriculum for Specialist Core Training in Psychiatry spx Aims of the Specialty Module: Adult Mental Health The module has been designed with several purposes, which we see as closely interrelated. We intend that it will enable you: to practise psychiatry at the highest possible standard, safely and at a level that is appropriate to your year of training and to prepare you for further specialist training in the future to link together various elements of your work, such as your clinical practice, your meetings with your educational supervisor, your personal study, and your revision for the MRCPsych examination to cover some of the College curriculum and examination syllabus to pass the MRCPsych examination The course aims to integrate these aims, making your postgraduate education a rewarding, fulfilling and, we hope, enjoyable experience. We very much believe that the whole is greater than the sum of the parts. This is a basic premise of the course. This module has been developed in conjunction with the curriculum / syllabus specified by the Royal College of Psychiatrists Edition

4 Structure of course B1 Adult Mental Health Module Summary timetable Date Topic Facilitators 7 September 2017 / 21 September September / 5 October October 2017 / 19 October October 2017 / 9 November 2017 Management of Schizophrenia including Resistant Patients Personality Disorders Clinical features and management (with focus on borderline personality disorder) Management of Depression including Resistant Patients Management of Bipolar Disorder including Rapid Cycling and Resistant Patients Dr Obed Bekoe Dr Ekta Mutta (ST6) De Geoff Searle Dr Stephen Ariaratnam Dr Sharn Bratton (ST6) Dr Nupur Tiwari Dr Foluke Odeyale (ST5) Lead Facilitators: Dr R Ramachandra Dr Mustafa Soomro Dr Wajid Iqbal (ST4) Lead Facilitators The lead facilitator is normally an experienced clinician who: - contacts the week s facilitators, and briefs them about the week s work and supports them on the day - gives trainees a concise introduction to the week s topic at the start of the session - ensures that an agreed work plan is received from the groups at the end of the planning session - introduces the masterclass contributor and chairs the discussion (where the masterclass is a presentation) - the lead facilitator can also be the person delivering the masterclass - ensures that the session runs to time - summarises the topic at the end of the session - allows time before the close of the session for trainees to reflect and to write summaries of their learning from the topic - encourages trainees to complete the feedback forms. 4

5 Learning Objectives for Each Topic The learning objectives are meant to be a guide and are not exhaustive. This module will focus more on advanced management options in common mental health problems such as schizophrenia, bipolar disorder and depression, and also on personality disorders (topics of adult mental health more relevant to Paper B of the MRCPsych exam). 1. Management of Schizophrenia a) understanding the different management options in complex patient with schizophrenia b) understanding the management of treatment resistance c) leaning about advanced pharmacological treatments in schizophrenia 2. Personality Disorders a) to learn about clinical features of different personality disorders b) to understand issues relating to co-morbidity and difficulties in diagnosis c) to learn about different management options of specific personality disorders 3. Management of Depression a) to learn about management of treatment for resistant depression b) to understand different management options in depression c) to learn about physical treatments, including ECT in depression 4. Management of Bipolar Disorder a) to learn about different pharmacological treatments in bipolar disorder b) to understand management of complex patients such as rapid cycling bipolar disorder and treatment resistant patients c) to learn about assessment of a patient with bipolar disorder Also, please note the tasks as listed in the detailed time table (next section) for respective topics are for guidance and may be changed nearer the time of the session. For each of those tasks we shall be developing and distributing case vignettes to help link the knowledge with practical issues of patient care. Trainees may wish to contribute their own case vignettes. 5

6 Detailed timetable Part Time Part B1 B1:1 Introduction to Specialty Module Adult Mental Health and to the topic: Management of Schizophrenia including Resistant Patients 7 September Group work and preparation for 21 September Dr Obed Bekoe Task 1: What really is Schizophrenia? Difficulties in the diagnosis of Schizophrenia. What is treatment-resistant schizophrenia and how is it managed? Task 2: Evidence for the efficacy of various pharmacological treatments: what do the guidelines say? What about the evidence for psychological and social interventions? Task 3: What are the conditions which co-exist with schizophrenia, and impact on its treatment? What about risk management in schizophrenia? Task 4: Management of Schizophrenia in special groups:- - childhood & adolescent onset - late onset/the elderly - in pregnancy - cultural & ethnic influences Each Learning Set discusses the Topic and their assigned group work, agrees individual tasks, and writes a work plan. At the end of the session the Learning Set hands a copy of this plan to the Lead Facilitator Masterclass - Management of Adverse Effects of Antipsychotic Drugs. Speaker: Dr Obed Bekoe Personal learning and reflection. Opportunity for self-study, small group study, CASC practice group. 21 September 2017 Plenary session: Recap of topic and tasks, clarification of programme for morning Group work, discussion within learning sets, preparation of work agreed on 7 September for feeding back main points to whole group and preparation of summary/revision notes Dr Obed Bekoe Dr Ekta Mutta (ST6) Plenary session: Learning sets feedback to whole group, allowing 10 minutes per group, followed by about 15 minutes discussion (leaving time for round up discussion at end of topic) Reflective practice and evaluation Break Part B Advanced Communication Skills Lunch 6

7 Part Time Part B1 B1:2 Introduction to the topic: Personality Disorders 21 September Group work and preparation for 5 October 2017 Dr Geoff Searle Task 1: How common is personality disorder - are there real differences over time and between cultures? Dr Stephen Ariaratnam Task 2: What are the strengths and weaknesses of diagnosis based on archetypes and clusters of traits? How have they changed through history? Task 3: Do treatments of personality disorder work if you judge them like drug trials? Are any effective or superior? Task 4: Is the prognosis of personality disorder changing? Is treatment cost effective? Whole Group task: Interview Skills for Personality Disorders Each Learning Set discusses the Topic and their assigned group work, agrees individual tasks, and writes a work plan. At the end of the session the Learning Set hands a copy of this plan to the Lead Facilitator Masterclass: tbc Speaker: Dr Geoff Searle Personal learning and reflection: Opportunity for self-study, small group study, CASC practice groups. 5 October 2017 Plenary session: Recap of topic and tasks, clarification of programme for morning Group work, discussion within learning sets, preparation of work agreed on 21 September for feeding back main points to whole group and preparation of summary/revision notes Dr Stephen Ariaratnam Dr Sharn Bratton (ST6) Plenary session: Learning sets feedback to whole group, allowing 10 minutes per group, followed by about 15 minutes discussion (leaving time for round up discussion at end of topic) Summary of topic Reflective practice and evaluations Break Part B Advanced Communication Skills Lunch 7

8 Part Time Part B1 B1:3 Introduction to the topic: Management of Depression including Resistant Patients 5 October Group work and preparation for 19 October Tasks to be advised by the facilitators Dr Nupur Tiwari Task 1: Historical concepts and treatment of depression Task 2: Genetics, neurochemistry and neurophysiology Task 3: Psychological interventions Task 4: Medications, ECT and treatment resistance Dr Foluke Odeyale Each Learning Set discusses the Topic and their assigned group work, agrees individual tasks, and writes a work plan. At the end of the session the Learning Set hands a copy of this plan to the Lead Facilitator Masterclass: Speaker: Dr Foluke Odeyale Personal learning and reflection. Opportunity for self-study, small group study, CASC practice groups 19 October 2017 Plenary session: Recap of topic and tasks, clarification of programme for morning Group work, discussion within learning sets, preparation of work agreed on 5 October for feeding back main points to whole group and preparation of summary/revision notes Dr Nupur Tiwari tbc Plenary session: Learning sets feedback to whole group, allowing 10 minutes per group, followed by about 15 minutes discussion (leaving time for round up discussion at end of topic) Reflective practice and evaluations Break Part B Advanced Communication Skills Lunch 8

9 Part Time Part B1 B1:4 Introduction to the topic: Management of Bipolar Disorder including Rapid Cycling and Resistant Patients 19 October Group work and preparation for 9 November 2017 Lead Facilitators: Dr R Ramachandra Task 1: Difficulties in diagnosis of Bipolar disorder. Is there a trend towards seeking a diagnosis of Bipolar disorder? What is Rapid Cycling disorder? Dr Mustafa Soomro Dr Wajid Iqbal (ST4) Task 2: Evidence for efficacy of various pharmacological treatments - what do the guidelines say? What about evidence for psychological treatments? Task 3: What are the conditions which co-exist with Bipolar disorder and impact on the management Task 4: Bipolar disorder in special populations: Pregnancy Children Elderly Issues to do with diagnosis and management Each Learning Set discusses the Topic and their assigned group work, agrees individual tasks, and writes a work plan. At the end of the session the Learning Set hands a copy of this plan to the Lead Facilitator Masterclass: Evidence based Management of Bipolar Disorder Speaker: tbc Personal learning and reflection: Opportunity for self-study, small group study, CASC practice group 09 November 2017 Plenary session: Recap of topic and tasks, clarification of programme for morning Group work, discussion within learning sets, preparation of work agreed on 19 October for feeding back main points to whole group and preparation of summary/revision notes Lead Facilitators: Dr R Ramachandra Dr Mustafa Soomro Co Facilitators: Dr Wajid Iqbal (ST4) Plenary session: Learning sets feedback to whole group, allowing 10 minutes per group, followed by about 15 minutes discussion (leaving time for round up discussion at end of topic) Reflective practice and evaluations Break Part B Advanced Communication Skills Lunch 9

10 Reading List Essential 1. Gelder M, Harrison P and Cowen P (2006) Shorter Oxford Textbook of Psychiatry 5 th Edition OUP Oxford 2. Stein G and Wilkinson G (2007) Seminars in General Adult Psychiatry (2 nd Edition) Royal College of Psychiatrists UK 3. Stephen Stahls Psychopharmacology (Latest Edition) 4. Andrew Sims Symptoms of the Mind (Latest Edition) regarding Psychopathology 5. Critical Appraisal (College Seminar Series) Royal College of Psychiatrists UK 6. ICD-10 Classification of Diseases (chapter on mental disorders) 7. Companion to Psychiatry Studies by Kendel Zelley (latest edition) Reference 1. Gelder M, Andreasen N, Lopez-Ibor J and Geddes J (2009) New Oxford Textbook of Psychiatry (2 nd Edition) OUP Oxford 2. Comprehensive Textbook of Psychiatry by Kaplan and Sadock (latest edition) 3. Psychopathology by Fish 4. DSM-5 Classification of Mental Illnesses This is not an exhaustive list, and facilitators will suggest references (which may include the above) to help trainees prepare for the tasks. Module leads for Adult Mental Health - Dr Raghavendra Ramachandra raghavendra.ramachandra@southernhealth.nhs.uk / Dr Mustafa Soomro mustafa.soomro@solent.nhs.uk

11 Library and IT facilities You will have access to Library facilities in your own local area and you will be able to use the library at Tom Rudd Unit on course days. You should ensure that you have a NHS Athens account: this is a username and password which allows you to use information resources paid for by the NHS. All NHS staff are entitled to an NHS Athens account. Your Learning Set will have a laptop, with internet access, to use in the Education Room on course days. Some useful websites are: and - locate libraries, search for articles / books / other publications, register for an Athens account, My Library facility - catalogue of what is available (books, journals, audiovisual, etc) in all libraries in the south west The Medical Search Initiative has developed electronic tools for use on the desktop, making it much easier for all NHS staff to check details while they are working. The tools created give easy access to reliable sources such as the British National Formulary, Medicines.org.uk and the National Library for Health Basingstoke, Southampton, Winchester and South West Hampshire: Dorset: East Dorset NHS Library Service, Haven Road, Canford Cliffs, Poole PGMC.library@poole.nhs.uk Isle of Wight: library@iow.nhs.uk Portsmouth: Salisbury: Beechlydene, Fountain Way, Salisbury SP2 7EP Education Centre, Salisbury District Hospital, Salisbury SP2 8BJ library.office@salisbury.nhs.uk Edition