• Announcements

    • Gurpal

      New question bank for paper B   05/11/18

      Please see the link below for a new question bank: http://www.superegocafe.com/online-courses/mrcpsych-paper-b-multiple-choice-question-bank/  
Sign in to follow this  
Followers 0
shubhavhegde

Last minute PMP-please discuss

6 posts in this topic

A recently widowed man wants to take his brother of the psychiatric ward. Patient has chronic schizophrenia and has been an inpatient for 30 years. How to Mx? (What are the criteria for allowing discharge? What is the role of the inpatient team? Would you take patient's views into consideration?)

Lady in 30s or so referred to you with history of resilient depression and recurrent self harming. Has been few years in psychotherapy with no improvement. How will you assess and manage? (What may be responsible for failure to improve? What factors may make her not benefit specifically from psychotherapy? Which psychotherapeutic interventions are available in this case? Briefly describe what each entails? Which has best evidence in this case-recurrent DSH? What is the natural history of this case if left untreated?)

Share this post


Link to post
Share on other sites

shizophrenic institutionalised man-------

I think in the first one we need to concenterate on the motives of the brother in taking him now.

Back ground information on the brother.

how often has he visited him in 30 years.

is he after our patients money (may be he is rich)?brothers job.

(Is he mentally ill, is he a alcoholic or gambler etc)

does he know the difficulties of looking after somebody who has been institutioanalised.

whether he is willing to coperate with the cpn visits etc .

our patients current mental state. ofcourse our patients wish.

Then probably look at the examiner begging him to lead you somewhere,more comments welcome

Share this post


Link to post
Share on other sites

after these information cpa meeting MDT approach planned change of care if he is moving out of area!!!

Share this post


Link to post
Share on other sites
A [highlight]recently widowed man [/highlight]wants to take his brother of the psychiatric ward. Patient has chronic schizophrenia and has been an [highlight]inpatient for 30 years[/highlight]. How to Mx? [highlight](What are the criteria for allowing discharge? What is the role of the inpatient team? [/highlight]Would you take patient's views into consideration?)  

 

Lady in 30s or so referred to you with history of resilient depression and recurrent self harming. Has been few years in psychotherapy with no improvement. How will you assess and manage? (What may be responsible for failure to improve? What factors may make her not benefit specifically from psychotherapy? Which psychotherapeutic interventions are available in this case? Briefly describe what each entails? Which has best evidence in this case-recurrent DSH? What is the natural history of this case if left untreated?)  

Assess brother`s reasons for taking the patient home?

How are the ADL?

Criteria.....supervised discharge if stable mental state in the ward.

In-patient team to assess the risk (relapse, compliance, self neglect, exploitation) and stability of the illness.

Share this post


Link to post
Share on other sites

Talk about Protection of Vulnerable Adults ( In case you have doubts about the brothers motive)

Share this post


Link to post
Share on other sites
Sign in to follow this  
Followers 0