Object Constancy

Object constancy is a principle of perceptual organization that refers to the ability of the brain to maintain a stable perception of an object, despite changes in its size, shape, orientation, or other aspects of its appearance. This ability allows us to recognize objects as the same, even when viewed from different angles or under different lighting conditions. Object constancy is important for navigating our environment and interacting with the world around us.

For example, imagine looking at a familiar object, such as a chair, from different angles. Despite the changes in its appearance, you can still recognize it as a chair and understand its purpose. This is because your brain is able to maintain a stable perception of the object, based on its learned knowledge of what a chair typically looks like.

Object constancy is a fundamental aspect of perception, and is essential for our ability to make sense of the world around us. It is also a key area of research in psychology and neuroscience, as it provides insights into how the brain processes and interprets sensory information.

Reference:

Brascamp, J. W., Knapen, T., & Blake, R. (2013). The dynamics of object perception. Trends in Cognitive Sciences, 17(2), 68-76.

Get Through MRCPsych CASC

Get Through MRCPsych CASC" is an excellent book for anyone preparing for the MRCPsych CASC examination. This book is written by a team of experienced authors who have a deep understanding of the examination format and the key competencies required to succeed.

The book is well-structured and covers all the major areas that are tested in the MRCPsych CASC exam. The content is presented in a concise and easy-to-read manner, with clear explanations and practical examples to illustrate key points.

One of the key strengths of this book is its focus on clinical scenarios, which are central to the MRCPsych CASC exam. The authors have included a wide range of scenarios, covering a variety of psychiatric disorders and clinical situations. Each scenario is accompanied by detailed guidance on how to approach the case, including tips on how to communicate effectively with patients and other healthcare professionals.

The book also provides helpful advice on how to manage time effectively during the exam, and how to deal with common challenges that may arise. The authors have included a range of practice questions and sample scenarios to help readers build their skills and confidence.

Overall, "Get Through MRCPsych CASC" is an invaluable resource for anyone preparing for this challenging exam. It is a well-written, comprehensive guide that covers all the key competencies and clinical scenarios that are tested in the MRCPsych CASC exam. I highly recommend it to anyone looking to pass the MRCPsych CASC exam.

MRCPsych CASC: Assessment of School Refusal

This MRCPsych CASC Sample Case assesses a child's refusal to attend school. It is important to consider several key factors when evaluating the situation.

First, it is crucial to determine the age of the child and whether they desired to attend the scheduled appointment. It is also important to determine who is currently responsible for their care and if they have any connections to CAMHS (Child and Adolescent Mental Health Services) or social services.

The duration of the child's refusal to attend school should also be considered, as well as the different perspectives on the cause of the refusal from the child, their parents, and the school. It is important to determine if the child is refusing other situations.

If the child is exhibiting signs of separation anxiety, it is important to note that they may have worries about the safety of their caregiver and follow them closely in all situations. It is also important to assess the potential risks to the child, to others, from others, and for neglect.

It is important to consider any history of drug and alcohol use and the impact of the school refusal on the child's life at home, at school (academically), and with their friends. A mental state examination should be performed, evaluating the child's mood (such as low mood) and any potential symptoms of psychosis. The child's level of anxiety should also be assessed, including any possible experiences of bullying, checking and washing behaviours, and any specific concerns they may have about the school or a teacher.

A comprehensive developmental and psychiatric history should be obtained, as well as any history of medication use. The child's past medical history and family history should also be considered.

The management of the child's refusal to attend school may involve a gradual return to school, liaison with the school to address any potential bullying, and involving an educational social worker and psychologist as necessary. Incentives for attending school may also be implemented, and group tutorials should be considered if the child falls academically behind.

Virtual Scenario

Psychiatrist: Good afternoon, thank you for coming in today. Can you tell me a little bit about your child and their recent refusal to attend school?

Parent: Yes, my son has been refusing to go to school for the past few weeks. He used to love going to school, but now he just refuses to leave the house in the morning.

Psychiatrist: I see. How old is your son?

Parent: He is 11 years old.

Psychiatrist: Is he refusing to attend any other activities or events besides school?

Parent: No, just school. He seems to have a lot of anxiety about it.

Psychiatrist: I understand. Have you or the school noticed any changes in his behavior, mood, or overall functioning?

Parent: He has become increasingly withdrawn and has been complaining of low mood. He used to have a lot of friends, but now he just wants to be alone all the time.

Psychiatrist: That's concerning. Has there been any history of bullying or other adverse events at school?

Parent: Not that we're aware of. The school hasn't mentioned anything, and my son hasn't talked about it.

Psychiatrist: I see. Can you tell me about his developmental and psychiatric history?

Parent: He has never had any major developmental or psychiatric issues. He's always been a happy and healthy child.

Psychiatrist: Okay, thank you. Can you tell me about any medications he is currently taking and his past medical history?

Parent: He is not currently taking any medications, and he has no significant past medical history.

Psychiatrist: Alright. And what about his family history, is there any history of mental illness or substance abuse in the family?

Parent: No, there is no history of mental illness or substance abuse in our family.

Psychiatrist: Okay, thank you. Based on what you've told me, it seems like there may be some anxiety or mood-related issues contributing to his school refusal. I would like to perform a mental state examination to get a better understanding of his current state.

Parent: Yes, of course.

Psychiatrist: After the examination, we can discuss potential management options, such as graded exposure to school, liaising with the school to address any potential bullying, and involving an educational social worker and psychologist as necessary. We may also consider using incentives for attending school and providing group tutorials if necessary.

Parent: That sounds like a good plan. Thank you for your help.

Psychiatrist: You're welcome. We'll work together to help your son get back to school and feel more comfortable.

Somatic Delusions

Introduction:

Somatic delusions are a delusion that can significantly impact a person's perception of their body and bodily functions. In this note, we will examine the definition, prevalence, causes, and treatment of somatic delusions.

Definition:

Somatic delusions are delusions in which an individual has a false belief or conviction about their body or bodily functions. The belief can manifest in various ways, such as a belief that the individual has a serious illness or medical condition, that parts of their body are missing or not functioning correctly, or infested with parasites or insects.

Prevalence:

Somatic delusions are commonly associated with psychiatric disorders such as schizophrenia, delusional disorder, or major depressive disorder with psychotic features. In addition, somatic delusions can also occur in medical conditions that affect the brain, such as dementia or traumatic brain injury.

Causes:

The precise cause of somatic delusions is not entirely clear. However, research suggests that factors such as genetics, environmental stressors, and abnormalities in brain function may contribute to the development of somatic delusions.

Treatment:

Treatment for somatic delusions typically involves a combination of medication and therapy, focusing on addressing the underlying psychiatric or medical condition causing the delusions. Cognitive-behavioral therapy (CBT) may also help address the patient's thought processes and beliefs about their body.

Conclusion:

Somatic delusions are a type of delusion that can have a significant impact on a person's perception of their body and overall well-being. Early detection and treatment can help individuals manage their symptoms and improve their quality of life.

References:

1. Somatic Delusions. Merck Manual. Retrieved from https://www.merckmanuals.com/professional/psychiatric-disorders/somatic-symptom-and-related-disorders/somatic-delusions
2. Somatic Delusions. Psychiatric Times. Retrieved from https://www.psychiatrictimes.com/view/somatic-delusions
3. Yonkers, K. A. (2018). Management of somatic symptom disorder. New England Journal of Medicine, 379(14), 1373-1382.

MRCPsych CASC: Assessment of an aggressive Patient in the Emergency Department

Scenario:

A patient with a severe psychiatric disorder has become aggressive. You have been called to assess him in the psychiatric emergency department. 

Introduction 

Assessing a patient with a severe psychiatric disorder can be a challenging task, especially if the patient is aggressive. It is essential to approach the assessment with caution and to prioritize the safety of both the patient and the assessing psychiatrist. Here are the steps for assessing a patient with a severe psychiatric disorder:

Establish rapport: 

The first step is to establish a rapport with the patient. This can be done by introducing oneself and explaining the purpose of the assessment. For example, the trainee psychiatrist can say, "Hello, I am Dr. [Name]. I am here to talk to you and assess how you are feeling."

Gather information:

The next step is to gather information about the patient's current symptoms and past medical history. This can be done by asking open-ended questions, such as "Can you tell me about your symptoms?" or "What led you to come to the emergency department today?"

Assess the patient's level of agitation:

The trainee psychiatrist should assess the patient's level of agitation by observing their behavior, body language, and speech. This can help to determine the level of risk the patient poses and whether additional safety measures, such as restraints, are needed.

Assess for suicidal and homicidal ideation:

The trainee psychiatrist should also assess the patient for suicidal and homicidal ideation by asking questions such as "Have you been thinking about hurting yourself or others?" or "Do you have any plans to harm yourself or others?"

Conduct a mental status examination:

 
The trainee psychiatrist should conduct a mental status examination, which includes assessment of the patient's mood, affect, thought process, and cognitive functioning. This can help to diagnose any underlying psychiatric disorders and determine the patient's level of functioning.

Make a diagnosis:

Based on the information gathered, the trainee psychiatrist should make a diagnosis and develop a treatment plan.

Sample Conversation

Here is a sample conversation between the trainee psychiatrist and the patient:

Trainee psychiatrist: "Hello, I am Dr. [Name]. I am here to talk to you and assess how you are feeling."

Patient: "I don't want to talk to you. Just leave me alone."

Trainee psychiatrist: "I understand that you may not feel like talking, but it's important that I assess how you're feeling to determine the best course of treatment. Can you tell me what led you to come to the emergency department today?"

Patient: "I just can't handle it anymore. Everything is too much."

Trainee psychiatrist: "I'm sorry to hear that. Can you tell me more about what's been bothering you? Have you been having any thoughts of hurting yourself or others?"

Patient: "Yes, I have been thinking about hurting myself."

Trainee psychiatrist: "Thank you for telling me that. I am here to help. I am going to make sure you get the care you need to feel better."

This is just a sample conversation and the exact questions and responses will vary based on the specific patient and their situation. The trainee psychiatrist should adapt the conversation to fit the patient's needs and level of cooperation.