Summary of NICE Guidance for First-Episode Schizophrenia > A complete assessment is mandatory before starting treatment For people with first-episode psychosis offer: ●        oral antipsychotic medication with ●        psychological interventions (family intervention and individual CBT.) Advise people who want to try psychological interventions alone that these therapies are more effective when delivered with antipsychotic medication. If the person still wants to try psychological interventions alone: offer family intervention and CBT agree a time (1 month or less) to review treatment options, including introducing antipsychotic medication     continue to monitor symptoms, distress, impairment, and level of functioning (including education, training, and employment) regularly. It is also mandatory to assess and monitor the physical health of the patients before commencing antipsychotics and during treatment. Especially Weight, BMI Blood pressure and pulse Serum li

Human Resources, Psychometric and Treatment Facilities you need to make the Forensic Evaluations Scenario The local authorities have requested you to provide forensic psychiatry support for prison services in your area. What are the various human resources, psychometric, and treatment facilities that you would require to make the forensic evaluations? Human Resources Forensic psychiatrist Forensic psychologist Occupational therapist Social worker Trained nurses Psychometric Tools Historical clinical risk management-20  Violence risk appraisal guide Psychopathy checklist Revised Sexual violence risk 20 Stalking assessment and management Spousal assault risk assessment guide General Scales PANNS HAMD IPDE HADS CAGE/AUDIT COWS Coloured progressive matrices  Treatment Facilities Seclusion rooms Electroconvulsive therapy rooms

Establishing a Geriatric (old-age) Clinic; Medications and their Principles, Psychometric Tools, and Intake Performa Scenario: In view of increasing needs for elderly population requiring psychiatric help, your medical superintendent asked you to develop a senior citizens' clinic in your hospital.  Enlist and classify all medicines that you will need.  State the principles on which you base your choices. Enlist 8 psychometric tests/scales you will need? Which information do you think you will consider while developing an intake proforma? Principles Of Prescribing Medications in the Elderly Avoid drugs with long-half-lives (increased already in this population because of reduced renal and liver function, increased volume of distribution and relatively higher body fat content) Avoid drugs that worsen cognitive function, keeping in mind the rates of dementia in this population. Keep in mind the risk of fall and over sedation with central depressants and the propensity to side effects.

Postnatal Causes of Learning Disability (Intellectual Disability) Postnatal causes of learning or intellectual disability include head injury, infections, neurodegeneration, and toxicities. A study on the causes of developmental disability found bacterial meningitis, child battering, vehicle-related injuries, and otitis media as the most common causes. However, a developmental disability is a broader term that can include motor developmental disabilities too. The results still give us an idea as this overlap heavily with causes of pure intellectual disability. See Table 1. Table 1: Most Common Causes of Developmental Disability Bacterial meningitis 31% Child battering 15% Motor-vehicle- related injuries 11% Otitis media 11% Postnatal causes of developmental disabilities in children aged 3-10 years -- Atlanta, Georgia, 1991. MMWR Morb Mortal Wkly Rep 1996 Feb 16 45 13

Interventions for Mental Health Promotion in The Community The World Health Organization has enlisted two types of interventions to promote mental health in the community; macro-interventions and micro-interventions.  Macro Interventions  Improving nutrition Improving housing Improving access to education Strengthening community networks Reducing the misuse of addictive substances Intervening after disasters Preventing violence Micro interventions Preschool educational and psychosocial interventions Reducing violence and improving the emotional well-being in the school setting Effective school-based interventions for mental health Improving the school ecology Multicomponent programs Reducing the strain of unemployment  Stress prevention programs at the workplace Improving the mental health of the elderly Interventions for Low-Income Settings Advocacy Empowerment Social support e.g. improving maternal health will improve mother-child attachment/bonding and outcomes for the child.