Psychiatry
Mood, psychotic, anxiety and neurodevelopmental disorders, and the Mental Health Act.
- Depression Diagnosing depression against ICD-11 criteria and working through NICE's less severe/more severe stepped-care pathway, including when to choose therapy, an SSRI, or both.
- Generalised Anxiety Disorder Recognising free-floating, uncontrollable worry against organic mimics like thyrotoxicosis, and stepping through NICE's four-step care model to CBT and sertraline.
- Panic Disorder Distinguishing panic disorder from cardiac and respiratory emergencies, and treating it with CBT or an SSRI rather than benzodiazepines, which reinforce avoidance.
- Phobias Specific phobia, social anxiety disorder and agoraphobia explained through graded exposure, with the applied tension technique for blood-injection-injury phobia.
- Obsessive-Compulsive Disorder Obsessions and compulsions distinguished from psychosis by insight, graded with the Y-BOCS, and managed with ERP and higher-dose, longer-trial SSRIs.
- Post-Traumatic Stress Disorder Re-experiencing, avoidance and hyperarousal beyond a month post-trauma, with trauma-focused CBT or EMDR as first-line treatment ahead of medication.
- Acute Stress Reaction The transient reaction to exceptional trauma in the first month, managed with practical support and watchful waiting rather than routine debriefing.
- Bipolar Affective Disorder Mania versus hypomania, bipolar I versus II, and why an antidepressant should never be started alone - plus lithium monitoring for long-term prophylaxis.
- Schizophrenia Schneider's first-rank symptoms, the dopamine pathways behind antipsychotic side effects, and the route from a first episode to clozapine for treatment resistance.
- Schizoaffective Disorder Why the diagnosis hinges on psychotic and mood symptoms being prominent together, and how that shapes treatment combining an antipsychotic with a mood stabiliser or antidepressant.
- Delusional Disorder Encapsulated, otherwise-preserved functioning as the clue to delusional disorder, its persecutory, jealous and erotomanic subtypes, and the risk they carry to named individuals.
- Psychotic Disorders A structured work-up for any new psychosis, plus acute and transient psychotic disorder, organic and substance-induced psychosis, and shared psychotic disorder.
- Personality Disorder ICD-11's move from named subtypes to a severity-and-trait model, the borderline pattern qualifier, and why DBT - not medication - is first-line.
- Eating Disorders Anorexia, bulimia and binge eating disorder differentiated by weight and compensatory behaviour, with SCOFF screening and the danger of refeeding syndrome.
- Somatic Symptom Disorder Why the diagnosis no longer requires symptoms to be unexplained, how positive signs like Hoover's distinguish functional disorders, and avoiding the harm of repeat investigation.
- Self-Harm and Risk Assessment The psychosocial assessment every presentation needs, why NICE says risk stratification tools must not decide management, and paracetamol overdose in brief.
- Substance Use Disorder The dependence syndrome, AUDIT and unit calculation, relapse prevention for alcohol and opioids, and why harm reduction counts as treatment.
- Alcohol Withdrawal The withdrawal timeline through to delirium tremens, chlordiazepoxide regimens and why liver failure changes the drug, plus thiamine before glucose.
- Opioid Withdrawal Withdrawal as the mirror image of opioid effects, titrating naloxone in overdose, methadone versus buprenorphine, and the lethal risk of lost tolerance.
- Gambling Disorder A behavioural addiction with no physical signs, very high suicide risk, and a well-recognised iatrogenic cause in dopamine agonists.
- Attention Deficit Hyperactivity Disorder Diagnosis across two settings before age 12, why it is missed in girls, stimulant choice and the growth and cardiovascular monitoring that goes with it.
- Autism Spectrum Disorder Social communication and sensory differences, masking, reasonable adjustments in healthcare, and the diagnostic overshadowing that shortens autistic lives.
- Gender Dysphoria Terminology, the ICD-11 reclassification out of mental disorders, the UK referral pathway, and screening by organ rather than gender marker.
- Postnatal Depression and Puerperal Psychosis Separating baby blues from postnatal depression from a psychiatric emergency, EPDS screening, and prescribing safely in pregnancy and breastfeeding.
- The Mental Health Act Sections 2, 3, 4, 5(2), 5(4), 135 and 136 with durations and signatories, and the distinction from the Mental Capacity Act that most errors turn on.
- The Mental State Examination Each domain in turn with the descriptive terminology that earns marks - mood versus affect, thought form versus content - and a worked presentation.
- Psychotropic Medication Antidepressants, antipsychotics, mood stabilisers and anxiolytics compared, with lithium and clozapine monitoring and the three psychotropic emergencies.