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Feedback on Part 2 Essay Paper spring 2007

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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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hope the essay wasnt too tough on guys...best of luck for the clinicals!

at least u can now take a deep breath. 8-)

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I answered question 2 which was:

'Psychosexual problems are neglected in psychiatric practice.' &nbsp:lol:iscuss this statement critically and the role of the psychiatrist in the assessment and management of psychosexual difficulties with particular reference to depression.

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Question 3:

Children and adolescents who present to psychiatric services with mental health problems continue to have difficulties in adult life.

Discuss this statement critically with reference to ADHD.

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There was an editorial on Adult ADHD in BJP Jan 2007 which was very good. People who read it would have found this essay easy to structure.

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dear heathen

i wrote about this topic as well, simply because i didnt have any idea about the othher 2

iam very worried about the assay, could share with me what did yoiu write ,be i think i messed it up

i wrote introduction defining psychsocil problem as there no specific defintion!!

i spoke about why its weak area in history( sensitive area to explore , doctor dont ask and patient dont reveal

male more comfortable with male intervierwer and vise versa

it can range from orgasmic problem, erectile dysfunction, decrease libdo

intial raport with patient is important ,take hx at second interviwe if you not able to explore this area intially.

and then spoke about psychsocial problem in depression

psychsocial problem it self can lead to depression

it can be sympotoms of depression it self or as result of the treatment

i then spoke about ssri side effect !!

management

good history taking even couple interview

i wrote generally biological intervention

replace ssri with mertazapine

add cyprohepatidne!!

Relationship councilling

sec clinic

CBT not detail though

conclusion its psychiatrist job for good hx !!

remain area of difficulty to approach!

i think i really messed it up as i could of written it in more systemised but id dont know i couldnt collet the information together so i think there was proble in flowing!! i wrote only 6 pages

thats all

i apprecite if you could give your view on the above as i am so worried!!

regardes

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Dear Kafiya,

i also wrote more on less on the same lines. i could not think more the that, but i also could not be more specific. lets hope all goes well.

rajkd

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the first essay question, which i attempted and so did most of my friends....

'Critically discuss the relative roles of genetics and environment in the aetiology of Schizophrenia'

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Always a safe bet for the College and candidate....essay on Schizophrenia!!! The others sound horrible!

Good luck for the clinicals....start now!

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Dear Kafiya,

I basically answered question 2 because I thought it required the least amount of knowledge, and I did not really do enough revision for this exam. I answered the question in a largely similar vein to you, but left out some of the very good points you put in! My essay was generally quite vague and waffley. &nbsp:lol:id not use any references either. &nbsp:lol:on't know if this is reassuring to you or not, don't think I am a very good candidate to compare yourself to!

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Heathen,

I did the same psychosexual essay.

Mine was waffly too and did not have references.

But I think I made up for it by structuring the essay well and arguing the different aspects of the problem well.

At the end of the day, who knows how the College is going to mark this! ;)

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Essay on schizophrenia

discuss causal factors for schizophrenia critically? smething like that

What is schizphr little bit about epidemiology life time risk sucicide risk M=F Eca study and all

aetiological factors

Environmental

Winter birth, cannabis , immigration , ethnicity, obstetric complication, LBW , life events High EE(mainly relapse) etc

but just evironmental factors dont lead to schizphr

Developmental aspects

British birth cohort low educational scores, NCPP, Dunedin study

Nueroimaging(do changes in brain cause schizophrenia)

Crow type 1 type 2

libermann et al nueroimaging findings

Trashed by winberger et al

Genetic factors all monozygotic twins data

neuregulin, dybindin ch13(Daoa G72/30),22,comt, 11bdnf, disc1 (craddoc et al)

but just genes do not mean person develops schizphrena

Nurochemical imbalance

Glutamate, dopamine, 5HT

cocaine, amphetamine can induce psychosis

Conclusion

no single factor causes schizophrenia

interaction between different factors

gave an example

Conclusion -a person predisposed to schizophrenia brain changes, not the brightest , low IQ , motor clumsiness, cant fit in the society, comes under stress and cant manage, so what does he do self medicate with cannabis which again increases the risk just an example of how different factors interact for someone developing schizophrenia

more research in future might increase our understanding

How does that sound is that enogh to PASS

do give ur views

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Essay on schizophrenia

discuss causal factors for schizophrenia critically? smething like that

What is schizphr little bit about epidemiology life time risk sucicide risk M=F Eca study and all

aetiological factors

Environmental

Winter birth, cannabis , immigration , ethnicity, obstetric complication, LBW , life events High EE(mainly relapse) etc

but just evironmental factors dont lead to schizphr

Developmental aspects

British birth cohort low educational scores, NCPP, Dunedin study

[highlight]Nueroimaging(do changes in brain cause schizophrenia)

Crow type 1 type 2

libermann et al nueroimaging findings

Trashed by winberger et al[/highlight]

Genetic factors all monozygotic twins data

neuregulin, dybindin ch13(Daoa G72/30),22,comt, 11bdnf, disc1 (craddoc et al)

but just genes do not mean person develops schizphrena

[highlight]Nurochemical imbalance

Glutamate, dopamine, 5HT[/highlight]

cocaine, amphetamine can induce psychosis

Conclusion

no single factor causes schizophrenia

interaction between different factors

gave an example

Conclusion -a person predisposed to schizophrenia brain changes, not the brightest , low IQ , motor clumsiness, cant fit in the society, comes under stress and cant manage,  so what does he do  self medicate with cannabis which again increases the risk just an example of how different factors interact  for someone developing schizophrenia

more research in future might increase our understanding

How does that sound is that enogh to PASS

do give ur views

i did exactly the same but did not include the highlighted points

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How does that sound is that enogh to PASS

do give ur views

Sounds good enough to me, you did well to write about all that in the time. 8-)

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Question 2..Thought it was a cake walk

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I answered question 2 which was:

'Psychosexual problems are neglected in psychiatric practice.'  Discuss this statement critically and the role of the psychiatrist in the assessment and management of psychosexual difficulties with particular reference to depression.

Hi, I also answered the question 2 and I just wanted to make slight modification to what you have posted ( as far as I remember ):

'Psychosexual problems are usually disregarded in psychitric practice.' Critically discuss this statement and the role of the psychiatrist in the assessment and management of psychosexual problems with particular reference to depression.

Anybody wants to make any further modifications???

With best wishes...

drbandla

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Hi Neeraj, You have really done well and I think you would definitely pass.

With best regards...drbandla

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:-X I also did the psychosexual problems essay, but on reflection, I thought the schizophrenia question was easier and somehow kicking myself!

I started by exlpaining what psychosexual problems are ( e.g amenorrhoea, reduced/loss of libido, impotence, premature ejaculation, failure to achieve orgasm. galactorrhoea, etc), stating the word 'psycho' implies psychological cause/origin.

Then explained some of the reasons why they are often disregarded in psychiatric practice, like talking about sex and sexual problems are often frowned upon in certain cultures, therefore sufferers and doctors are often uncomfortable talking about them. Then talked about the fact that certain conditions like depression, schizophrenia and the medications (antidepressants, antipsychotics, etc) used to treat them can cause psychosexual problems.

I pointed out why the topic was important: the problems are common and can cause considerable distress to sufferers, their partners and families and often lead to medication non-compliance/concordance.

For the sake of counter argument, I did state that there are very good and conscientious doctors who ask about these problems and pay attention to them( remember the question was psychoseual problems are often disregarded in psychiatric practice. Critically appraise this statement, paying attention to assessment and management with regard to depression).

I then listed the key features of depression, using te ICD-10 criteria and decreased/loss of libido was one of them. In the assessment I stressed the importance of :

-full history (the onset, duration, nature, progression), paying attention to predisposing, precipitating and maintaining factors, including use of psychtropic medications

-mental state examination

-physical examination, especially the endocrine organs e.g thyroid glands, etc

-ordering relevant routine blood investigations and others where indicated (e.g prolactin levels)

Management: by this time, the time was ticking very fast and my hand writing started to deteriorate and I wasn't thinking very coherently. But managed to say management would depend on assessment and this should be multi-disciplinary, paying attention to biological. psychological and social factors. Managed to say other specialists (endocrinologists, urologists, gynaecologists) should be contacted for advice/opinion when and where necessary.

At this stage I was waffling and the time was not helping either. A minute to go and I'm yet to start the conclusion. However, was able to say psychosexual problems are common and psychiatrists should be aware of these. I mentioned education both for patients and doctors is important and----------viagra should be prescribed when indicated.

I thought I started well but somehow petered out at the end. What do you think? I welcome comments.

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I would say that is a decent effort and you have certainly done the justice to the topic!!Chill :)

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hey guys,

I am preparing for this time.I had attempted the psychosexual essay.i had used some relevant references and arguments.I was really surprised and annoyed when I received the feedback of failure.The comments included 'your essay focussed on how psychosexual problems are neglected in practice and need for more attention' ; I thought that was what the question meant to appraise.So made me think that we need some luck as it also is influenced by examiner's perception of the question.

:-[

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