Get Through MRCPsych Parts 1 and 2: 1001 EMIQs Get Through MRCPsych Parts 1 and 2: 1001 EMIQs is an excellent and essential revision guide for all candidates taking the Membership examinations. This is one of the first EMIQ books for the MRCPsych examinations. The Editor, Albert Michael, has written several successful MRCPsych texts and is a Consultant Psychiatrist. He and his team of 16 international contributors have created a unique selection of 1001 questions spread over the 200 themes which form the MRCPsych syllabus. Topics featured include: learning theory * diagnosis of eating disorders * uncommon syndromes * delerium * memory disorders * cognitive function tests * psychometry * couple therapy * drug dosing * mood stabilisers * dynamics of adverse effects * management of schizophrenia * child abuse * developmental syndromes * statistical concepts

Intermittent Explosive Disorder Intermittent explosive disorder (IED)  involved o utbursts of impulsive aggression with no persistent mood disruption   between the outbursts.   It requires only  3 months  for the total duration of two episodes  every week on, average.  There must have been At least three episodes with damage to property or injury to humans/animals  w ithin 12 months. It is diagnosed only if age is above 6 years.  A man with explosive outburst depicted in a painting See the ICD-11 Criteria for Intermittent explosive disorder here.  Deficits in the prefrontal cortex on MRI have been associated with impulsivity (can aid diagnosis). 1 Findings of Etiological (but not necessarily diagnostic importance): Reduced prefrontal grey matter >> antisocial personality disorder . 2 Reduced amygdala volume has been associated with a lack of empathy . Increased amygdala responses to anger stimuli > Intermittent explosive disorder Elevated CSF testosterone >> a

Obsession An obsession is an intrusive thought or impulse that enters the mind despite efforts to exclude them. Most of the time, patients consider them false and totally against their own beliefs. For example, someone might think their hands are dirty and thus repeatedly wash their hands. But notice they clean their hands to reduce the distress of their intrusive thoughts. That is, they know their hands are clean, but due to the intrusive thoughts of dirt, they want to ensure that their hands are clean again. 

Delusion Definition and Types A delusion is an unshakeable belief (we cannot change it with logical explanations or evidence) that is held on inadequate grounds (they do not have a valid explanation or evidence for their belief, and that is not a conventional belief that the person might be expected to hold given their educational, cultural, and religious background.   Illusions are mostly but not always normal. Hallucinations are mostly but not always abnormal. But a delusion is something that is always abnormal. So, someone who believes to be possessed by the supernatural is not delusional because it’s a cultural common belief. In the west, many young girls become convinced that they need to be thin and take extreme measures, and their weight may reach life-threatening low levels and continue. And this is still not a delusion because they consider thinness socially desirable and they educate most people about the risks of obesity is dangerous and the need for thinness. Persecutory de

Loosening of Association A loss of the normal structure of thinking.  The patient’s discourse seems muddled and illogical and does not become clearer with further questioning; there is a lack of general clarity, and the interviewer has the experience that the more he/she tries to clarify the patient’s thinking, the less we understand it.   Loosening of associations occurs mostly in patients with schizophrenia. Earlier psychopathologists have described three kinds of loosening of association: Knight’s move thinking ( Derailment , Entgleisen ):  There is a change in the train of thought. There is retained but misled determining of the objective of thought. There is a disordered intermixture of constituent parts of one complex thought.  Talking past the point ( vorbeireden )  where the patient gets close to the point of discussion, but skirts around it and never actually reach it Verbigeration (word salad, schizophasia, paraphrasia)  where speech is reduced to a senseless repetition of so

Disorders of the Form of Thought Form of thought Form of thought is the way people experience or express thoughts and the way thoughts proceed one after the other irrespective of their quantity. It helps in the diagnosis of psychiatric disorders. Normal thinking forms include the following.  Dereistic Thinking (daydreams) Imaginative thinking Rational thinking Formal Thought Disorder The term ‘formal thought disorder’ is a synonym for disorders of conceptual or abstract thinking that are most seen in schizophrenia and organic brain disorders. In schizophrenia, disorders in the form of thinking may coexist with deficits in cognition, and these forms of thought disturbance may prove difficult to distinguish in certain cases. Cameron used the term ‘Asyndesis’ to describe the lack of adequate connections between successive thoughts. Cameron placed particular emphasis on ‘over-inclusion’, which is an inability to narrow down the operations of thinking and bring into action the organized att

Physical Examination in Case of Alcohol Use Disorder The examination begins with an inspection of the general demeanour and physique.  General Physical Examination  On general physical examination, observe signs of agitation, sweating, and bruises and note the respiratory rate.  Agitation or restlessness   Sweating   Bruises  Respiratory rate   Examination of hands and arms Examine the arms and hands for signs of hepatic disease or cerebellar dysfunction (tremor/dysdiadokokinesia and finger-nose test).  Inspect for Palmar erythema Dupuytren’s contracture   Clubbing   Koilonychia   Nicotine stains