New: The Maudsley Practice Guidelines for Physical Health Conditions in Psychiatry  Authors : David M. Taylor, Fiona Gaughran, Toby Pillinger The Maudsley Practice Guidelines for Physical Health Conditions in Psychiatry provide an evidence-based and practical approach for psychiatric and general practitioners to screen, investigate, and manage common physical health conditions observed in persons with severe mental illness. The book bridges the gap between psychiatric and physical health care for the seriously mentally ill and is written by an extraordinary team of acknowledged professionals in medicine, surgery, pharmacy, dietetics, physiotherapy, and psychiatry. The Maudsley Practice Guidelines for Physical Health Conditions in Psychiatry cover the following:  Assessment and care guidelines for well over a hundred various medical and surgical presentations encountered often in persons with major mental illness. Physical health emergencies in the psychiatric context. Evidence-based m

Age Disorientation in Schizophrenia Age-disoriented patients are cognitively more impaired than their age-oriented counterparts. Whether the cognitive impairment is present to a greater degree premorbid among these patients, studies have not yet established this, but some data support this. Others have reported that rated school performance and grade-level do not distinguish age-disoriented from age-oriented subjects. Some have suggested that marked cognitive decline occurs following the first break.  Harvey et al. reported that age-related decline in mini-mental state examination scores is dramatically greater among age-disoriented schizophrenia patients than age-oriented subjects, consistent with more rapid deterioration. Examination of the specific PANSS items revealed that the age-disoriented group was consistently more delusional and more conceptually disorganized and showed increased stereotyped thinking, motor retardation, unusual thought content, disorientation, and poor attent

What are the advantages of open-ended questions? During the clinical assessment, open-ended questions are always preferred to close-ended questions. there are several advantages to the open-ended questions.  If you still don't know What are Open-Ended Questions? Open-ended questions allow patients to start talking about themselves and puts them at ease as they have the floor.  Allows you time to think and plan areas of questioning as you assess their style and content of the response. Allows a period of non-verbal response from interviewer; listening and facilitating.  >> Just slight info: To Have the floor means to have the right or opportunity to speak in a group, especially at a formal event or gathering.  Please, Dr. Dunstaple, your colleague has the floor. You'll have the opportunity to reply when he has finished speaking. 

Clinical Vignette: Management of a Patient with Treatment-Refractory Depression Mr X is a known case of depressive illness for the last 1 year. He has stopped responding after two different groups of antidepressants were tried and has been labelled as a patient of treatment-resistant depression.  How will you assess the cause of this resistance? Write the treatment algorithm that you will follow for his management? If you had to start lithium in this case, what protocol would you follow to start it and how will you monitor it? Treatment Options for Refractory Depression

A 33-year-old man who is a driver-by-profession presented to you with decreased appetite, loss of sleep, and irritability for the last three months. There is no past or family history of psychiatric conditions. He is the only earning member of his family and must go to work every day to make a living. On physical examination, his pulse is 90 beats per minute with an irregular rhythm. a) Outline your assessment and management plans. b) What precautions you will take while prescribing psychotropic medications in this case? c) Enumerate all possible differential diagnoses in this case.