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Feedback on Part 2 Essay paper Autumn 2005

40 posts in this topic

After the written exam, please post your experience of the essay paper. If you can remember the essay questions, please post them. Thanks!

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Q1 Discuss the concept of 'compliance'. critically review this in relation to the management of patients with scizophrenia.

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Q2 'adult mental health services are overly foccused on individual patients rather than families' Discuss  this statement   in relation to the treatment of eating disorders.

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Q3'Multi-axial classification is essential in the understanding and treatment of psychiatry disorders.' Discuss with specific refernce to autism and its diagnosis and management.

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i answered tne 2nd essay on tx of eating disorderd in terms of 'carer burdens and their psychological needs'-j carers as partners of health

how appropriate is this?

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i answerd the second question as well but didnot use the article on carer burden by oyebode because i felt that was related more to older  patient mainly those surfering from dementia,there is an article in bjpsych march 2004 on disturbed family with reference to eating disorder i actually saw this article this evening after the exams. Good luck to all of us on result day.

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the question initially looked straight forward but then it specified 'Adult' mental health sevice and eating disorders(including obesity!)-God help us!

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I answered Qi and i think covered reasonably well but the examiners should think i covered well isn'it..

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I answered q1 basically I started by giving definition with an opening statement and then epidemiology and then I explored more towards the compliance as factor related to the patient such as psycho demographic data then relation to illness then relation to doctors after that I wrote about the effect of compliance on the public and then on the government .2nd part of the q I covered the management with the same (Alac Bushnan ) and Murry research in psychiatry also I wrote things related to EE then I closed all with considerable conclusion I don’t know is that good or not ,I did not prepared for any topics ut I used the general themes

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i answered q1 , coz i thought it was the safest bet.feeling good about it. but had to rush through conclusion

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I am sure the royal college would have taken more time to frame these questions, than the time they gave us to integrate our knowledge and write decent essays.

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hi guys,

i was stupid to have answered Q3- autism and multi-axial c.s. I struggled and finally got drawn. Only God can salvage me otherwise i guessed it is FAIL. ???

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I did Question 1...

Rough structure...

-Introduction, definition of Compliance

-Sick role (Referred to Parsons)

-Role of compliance in health care

-Compliance and Consent

-Detained treatment Vs. Compliance (Institutionalisation - Goffman reference)

-Compliance and Concordance

-Compliance and Mental Health

-Definition of Schizophrenia (bastardised RCPsych quote)

-Compliance and Schizophrenia

-Biopsychosocial model of illness/treatment

-Biological treatments, role of compliance

-Supervision of administration of medicines

-Depots and Clozapine monitoring

-Psychological therapies

-Compliance as attendance and engagement

-Compliance enhancing role of Psychological therapies

-Compliance and Insight, how they are related.

-Social treatment

-Stigma (Changing minds campaign 1998-2003)

-High EE

-Complying with advice

-Social drift -> Drug exposure, comply with advice not to take drugs (Andreasson and Prof. Murray reference)

-Conclusion, due to Mental Health law compliance is non-essential but with it patients have access to a wider variety of treatments and can make a decision, without it they are spiralling into a cycle of detained admissions.

-Compliance therefore highly desirable.

I HOPE this is somewhere in the ballpark of what they wanted. I was running out of time by the end...

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Not surprised that's quite a hefty list!!

but have to say sukiyaki -thats some memory ...almost exactly how i remembered them!!

A few friends saw an essay 'panelist', just before the exams shse said:

-loads of essay titles get submitted all the time upto about 2-3months before the exam.

-Prof Oyebode 1-2weeks before opens up the bank and picks out the essay. only he + 2-3 admin staff then know the actual questions.

-we all panic in the exam (well ok i added that last bit in but you get the picture)! ;)

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she also said that -in terms of writing the essay:

-references is not important and will only gain marks if you explain it. Ie if you happen to know Prof Treasure has something to say on most things in ED -you cant just guess and put Treasure et al 2003 (although in this case it would probably be a good guess!), to score you should put what she found/said in 2003. (obvious i suppose but worth a shot)

-take a balanced view, and explain both sides of the story.

-dont be contraversial or clever

-dont quote from philosophers unless realy necessary! (b@l#ks!!)

-in the conclusion you dont necessarily need to come to a definative answer (if there was one) but just bring the points together.

all obvious and great ...but really who couldnt resist the gratuitous quote?? ;)

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8) 8)scribb,that looks like a great list, i'm sure you will do well, ignore the envious jabs. 8)

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I think this essay was for those who worked in child psychiatry and if you have then its easy to write. Multiaxial classification is the basis of diagnosis and management in child psychiatry because you have to take an overall picture of the child. In autism it even becomes important because autisim is confused not only with neurological disorders but it can be comorbidly present with diseases like ADHD, schizophrenia, Tourette and it might need a detailed assessment to come to a definitive diagnosis. There is no medicla treatment but social, educational, psychological and carer support are very important components of treatment. In our academic unit we also use AUTISM SCREENING QUESTIONARRIE which we do on the phone with the parents before we see the child in the clinic. Another important component to take into consideration is the learning disability which can make not only diagnosis of autism difficult but also its management.

So you see the role of multiaxial classificiation. It is inherent in DSM but here we tend to use ICD and we tend to limit to only Axis 1 most of the time. But ideally I think for all the patients adult or children a multiaxial format should be used because it gives an overall picture and helps in planning treatment on biopsychosocial model

Dr Hussain Specialist Registrar Child and Adolescent Psychiatry Cardiff

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Good source  for Q1 is a presentation  Delivered by prof john kane on 'compliance  in schizophrenia',is on psychiatry 24x7.com sponsored by janssen cilag . i will not be surprise to know  that  the person that set the question must ve listened to the presentation.

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Cann't still believe the shocker.

Answered q.2.

Does anyone know exactly what was wanted here?

(or think was wanted?)

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am delighted that prof oyebode opens a letter and selects an essay title. Big deal, he cant open letters and deal with compliants too well...

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Hi Grace check out bjpsych march 04 disturbed families,or families disturbed in relation to eating disorder,i think this answer most part of the question.

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Hi Grace check out bjpsych march 04 disturbed families,or families disturbed in relation to eating disorder,i think this answer most part of the question.

In addition to the reference above I think the initial statement for Q2 -Mental health services focus overly on the individual patient without the families (or something similar) is actually a qoute from Nick Hervey's editorial in the March 2004 APT.

That editorial which I only found after the exams is worth a read.It cites the relevant policies and gives a historical perpective to Carer involvement in Health services.

I've read Jan Oyebode's paper on carer burden and I'm agreeable with the school of thought that proposes it is more relevant to answering a Dementia question as opposed to an Eating disorder one.However General principles can still be gleaned fronm Oyebode's paper.

Best wishes to everyone.

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Thanks sukiyaki. (that put the final nail on my coffin).

I have just read the article.

In retrospect, i don't know what possessed me to answer that question.

I wonder if the college are also capable of making one unconsciously answer a question against one's wish(!!?!!)

I would have been better off with Q.1.

Terrible.

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I agree with sands73 with regard to Essay question no 2.

Eating disorders in most of the cases have the onset in their adolescence. Most commonly these individuals are identified in their adolescence. I'm not sure as i have never worked in CAMHS team but i guess it has to be the CAMHS team who get the initial referrals. The question has its ideas about CAMHS team focussing on family.

This particular article ''mind the gap:...' talks about the interface between CAMHS and Adult mental health services.

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Que1 required that you critically discussed compliance. ie ' Although the atypicals have better side effects profile and better tolerated than the typicals, they are not without their own problems such as agranulocytosis, metabolic syndrome, cardiac toxicity etc, this has effect on adherence to treatment.'

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