Normal Pressure Hydrocephalus Overview Normal pressure hydrocephalus is a condition that is not due to a block within the ventricular system. Still, there is an obstruction in the subarachnoid space, preventing cerebrospinal fluid (CSF) from flowing over the ventricles. This condition is more common in the elderly. Aetiology A history of subarachnoid hemorrhage (SAH), head injury, or meningitis may be associated with the development of normal pressure hydrocephalus. Clinical Features The clinical features of normal pressure hydrocephalus include progressive memory impairment and dementia, slowness, marked unsteadiness of gait, and urinary incontinence. Investigations The removal of 50 ml of CSF can lead to a temporary improvement in cognition. CT or MRI can show dilatation of the ventricular system and relatively normal sulci. Periventricular lucencies can also be found on MRI. Management The treatment for normal pressure hydrocephalus involves the insertion of a shunt to improve the c...

Overview Creutzfeldt-Jakob Disease is a rapidly progressive degenerative disease of the nervous system that can be transmitted by blood or tissues between human beings. Epidemiology It is estimated that 50-100 cases occur each year in the UK, with an equal sex ratio and onset typically occurring between the ages of 40 and 60. Aetiology The disease is caused by the accumulation of an abnormal prion protein in the brain, which is encoded on chromosome 20. Those with the E4 allele of apolipoprotein are at a higher risk of developing the disease, and the familial form, known as Gerstmann-Straussler-Scheinker, accounts for 10% of patients and principally affects the cerebellum. It is also autosomal dominant. Clinical Features Clinical features of the disease can include personality changes, seizures, intellectual deterioration, and neurological deficits such as cerebellar ataxia, spasticity, extrapyramidal signs, and myoclonus sensitivity to noise or touch. In new-variant CJD (nvCJD), initi...

Sensate focus: Masters and Johnson (1970) Introduction: Sensate Focus is a psychosexual therapy technique developed by William Masters and Virginia Johnson in the 1970s to address sexual dysfunction in couples. The technique involves non-sexual touching exercises that are designed to help couples focus on physical sensations and enhance their communication around sexual needs and desires. This article reviews the Sensate Focus technique, its stages, and its effectiveness. Stages of Sensate Focus: Sensate Focus is a three-stage process that gradually introduces sexual touch as the couple progresses through each stage. The first stage involves non-genital touching, where couples touch each other's bodies in a non-sexual way, focusing on the sensations of touch and skin contact. The second stage involves genital touching, where couples explore each other's genital areas, again focusing on physical sensations rather than sexual performance. The final stage of the technique involves...

Prejudice, Stereotypes, and Intergroup Hostility: A Structured Overview Introduction Prejudice, stereotypes, and intergroup hostility are interrelated concepts that can have a significant impact on social relationships and attitudes between different groups of people. This article will provide a structured overview of these concepts and examine how they are related. Prejudice Prejudice refers to an unjustified negative attitude toward an individual or group based on their membership in a particular social category, such as race, ethnicity, or religion. Prejudice can take many forms, including racism, sexism, homophobia, and xenophobia. It is important to note that prejudice is not the same as discrimination, which refers to the unequal treatment of individuals or groups based on prejudice. Stereotypes Stereotypes are oversimplified generalizations about individuals or groups that are made without considering each individual's unique qualities and characteristics. Stereotypes are of...

Factors Associated with Risk of Repetition of Attempted Suicide Previous Attempt: Individuals who have previously attempted suicide are at a higher risk of repeating the attempt. This is because past attempts may indicate a higher level of psychological distress and a greater likelihood of attempting suicide again in the future. Personality Disorder: People with personality disorders, such as borderline personality disorder, are also at an increased risk of repeating attempted suicide. These disorders can cause significant emotional instability, impulsivity, and difficulty regulating emotions, which can contribute to suicidal thoughts and behaviors. Criminal Record: Those with a criminal record are at a higher risk of repeating attempted suicide. This may be due to a history of substance abuse, impulsivity, and aggression, which can increase the risk of suicidal behavior. History of Violence: Individuals with a history of violence are also at an increased risk of repeating attempte...

Best of Five MCQs for MRCPsych Paper 3 Palaniyappan, L. and Krishnadas, R. Published: 25 March 2010 Following the recent changes to the syllabus and MRCPsych exam by the Royal College of Psychiatrists, this book contains 450 multiple-choice questions to help psychiatry trainees to prepare for Paper 3 of the exam. Supporting these MCQs are detailed explanatory answers and revision notes referenced to the key textbooks used by trainees. The book's content matches the MRCPsych syllabus and includes practice papers for true exam preparation. Reference Type:  Book Record Number: 508 Author: Palaniyappan, L. and Krishnadas, R. Year: 2010 Title: Best of Five MCQs for MRCPsych Paper 3 Publisher: OUP Oxford Short Title: Best of Five MCQs for MRCPsych Paper 3 ISBN: 9780199553617

Escape and Avoidance Conditioning: Understanding and Applying the Concepts Introduction Escape and avoidance conditioning are two types of classical conditioning that are used to explain how animals and humans learn from their environment. These concepts have been studied for decades and have important applications in fields such as psychology, education, and animal training. Escape Conditioning Escape conditioning is a type of classical conditioning in which an organism learns to avoid or escape from an unpleasant stimulus by performing a specific behavior. In other words, escape conditioning is the process of learning to remove oneself from an aversive situation. An example of escape conditioning can be seen in a dog that learns to jump over a fence to escape a painful shock. The dog associates the shock with the fence and learns to escape the aversive situation by jumping over the fence. As a result, the dog's behavior is shaped through reinforcement, as the escape behavior resu...

Intergroup Behaviour Introduction Intergroup behaviour refers to how individuals or groups of people interact with and relate to one another based on their membership in different social categories such as race, ethnicity, gender, nationality, or religion. This field of study has long been of interest to social psychologists as intergroup behaviour has the potential to lead to both cooperation and conflict. Social Identity Theory One of the most well-known theories of intergroup behaviour is Social Identity Theory, which was first proposed by Henri Tajfel and John Turner in the 1970s. According to this theory, individuals derive a sense of self from their membership in social categories or "ingroups." Social identity theory suggests that individuals are motivated to enhance the positive image of their ingroups, leading them to act in ways that benefit their ingroups, while negatively evaluating "outgroups" that do not belong to their ingroup. This can result in inte...

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 psy...

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 mana...

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 pote...

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 entirel...

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...

CASC Notes: Emergency Assessment of an Angry or Anxious Patient or Relative As you enter the station, it is important to show your badge to the examiner and nod while saying a quiet "Thanks". When you meet the relative or patient, they may be standing up, so it's best to start by taking a seat yourself. You can say, "Hello, my name is Dr Waleed. Thank you so much for agreeing to see me today. Do you mind if I take a seat?" Starting with a calm and friendly approach is crucial in building rapport with the patient or relative. You can say, "First of all, thank you so much for coming to see me today. Good communication between patients or relatives and the psychiatry team is very important to us, and we value it greatly." You can also express your empathy and acknowledge their difficult situation by saying, "I can't imagine how difficult it must be as a mother/father/sister/carer to see your loved one suffering like this." If the relative or...

How to Prepare for the MRCPsych CASC Exam Introduction What is the MRCPsych CASC exam? The MRCPsych CASC (Clinical Assessment of Skills and Competencies) exam is a competency-based examination that assesses the practical skills and knowledge of mental health professionals in the field of psychiatry. The exam is designed to test the ability of candidates to manage complex clinical cases and make appropriate decisions in a simulated clinical setting. Why is it important for mental health professionals? The MRCPsych CASC exam is a crucial step for mental health professionals who want to attain consultant level in the field of psychiatry. It is also a requirement for those who want to work in the UK National Health Service (NHS) as a consultant psychiatrist. Passing the MRCPsych CASC exam demonstrates that a mental health professional has the necessary skills and knowledge to provide high-quality care to patients. Set Realistic Goals Determine your current level of knowledge and skills Bef...

Attitude Change and Persuasive Communication Attitude change is a common phenomenon that refers to modifying an individual's feelings, beliefs, and evaluations towards a particular object, person, or event. Attitude change can occur due to a variety of factors, including persuasive communication. Persuasive communication refers to messages that are designed to influence an individual's attitudes, beliefs, or behaviors. Persuasion can take many forms, including advertising, political campaigns, and interpersonal communication. One of the key factors that contribute to the effectiveness of persuasive messages is the source of the message. Individuals are more likely to be influenced by messages from credible, trustworthy, and likable sources. Another important factor that contributes to attitude change is the type of message. Messages that are argumentative and provide strong evidence and reasoning tend to be more effective at influencing attitudes than messages that simply expre...

Attitudes: Components and Measurement by Thurstone, Likert and Semantic Differential Scales Introduction Attitudes are complex psychological constructs that reflect an individual's positive or negative feelings, beliefs, and evaluations about a particular object, person, or event. Attitudes are crucial in shaping behaviour and influencing information processing and decision-making. To better understand attitudes, researchers have developed various frameworks and measurement tools to assess them. Components and Measurement by Thurstone One of the earliest frameworks for understanding attitudes was developed by Louis Thurstone, who identified seven primary attitudes that individuals hold: pleasure, displeasure, approval, disapproval, favourable, unfavourable, and neutral attitude. According to Thurstone, attitudes can be measured by determining the strength of an individual's feelings towards an object or event, with stronger attitudes indicating more intense feelings and evaluat...

Optimal Conditions for Observational Learning Observational learning, also known as social learning or modelling, refers to the process of acquiring new information or behaviours through observing others. The following conditions have been identified as optimal for observational learning: Attention: The observer must observe and learn from the modelled behaviour by paying attention. (Bandura, 1977) Retention: The observer must be able to retain the information observed to use it in the future. (Bandura, 1977) Reproduction: The observer must have the physical and cognitive abilities necessary to reproduce the observed behaviour. (Bandura, 1977) Motivation: The observer must be motivated to perform the observed behaviour. This can include intrinsic motivation (e.g., personal interest in the behaviour) and extrinsic motivation (e.g., rewards or punishments associated with the behaviour). (Bandura, 1977) Relevance: The observer must perceive the behaviour as relevant to their own life to b...

Leeds Dependence Questionnaire Raistrick, Bradshaw, Tober, Weiner, Allison, Healey | 1994  A self-report instrument called the Leeds Dependence Questionnaire (LDQ) assesses the level of dependence in people with substance use disorders. The questionnaire was created by a research team at the University of Leeds in the UK and released for the first time in 1994. The LDQ has 20 questions that look at many aspects of drug dependence, such as how much a person's drug use gets in the way of their daily lives, how strong their need is, how important the drug is to them, and how much they can control how much they use. Usually given as a self-report questionnaire, the LDQ takes between 10 and 15 minutes to complete. The responses are evaluated from "not at all" to "always." The overall score, which reflects the intensity of the reliance, is created by adding the scores from each item. The LDQ has been used in numerous research to evaluate the degree of dependence in pe...

Hypofrontality in Schizophrenia Hypofrontality, or reduced activity in the brain's frontal lobes, is a well-established feature of schizophrenia. The frontal lobes are responsible for various executive functions, such as planning, decision-making, working memory, and inhibitory control, which are often impaired in individuals with schizophrenia. Proposed mechanisms Several studies using neuroimaging techniques, such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), have shown reduced activation or metabolism in the frontal lobes of individuals with schizophrenia compared to healthy controls. This hypofrontality has been linked to the negative symptoms and cognitive impairments commonly observed in schizophrenia. reduced blood flow reduced dopaminergic activation reduced metabolism However, it is important to note that hypofrontality's exact nature and causes in schizophrenia are not yet fully understood and require further research. Additio...