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Clinical Psychiatry

Clinical Psychiatry Thursdays 9:30-12:00 (most days) Exams Students will need their laptop in class on exam days to login and complete their online exam. Course Overview Outline Objectives Project #1 Project #2 Faculty Textbook Evaluation Grading Bonus Attendance

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Clinical Psychiatry

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  1. Clinical Psychiatry Thursdays 9:30-12:00 (most days) Exams Students will need their laptop in class on exam days to login and complete their online exam.

  2. Course Overview Outline Objectives Project #1 Project #2 Faculty Textbook EvaluationGradingBonus Attendance

  3. Models of Disease & Interviewing • Biological system • Psychological System • Social system

  4. Meaning of Being Sick • Illness Behavior • Sick Role • Product of the Medical System • Secondary Gain

  5. Doctor-Patient Models • Active-passive • Teacher-student • Mutual participation model • Friendship model

  6. Effective Interviews • Assessment of Problem • Develop and maintain therapeutic relationship • Communicate Information • Implement Treatment Plan

  7. Interviewing Techniques • Clinical Interviewing • Develop Relationship/Problem Identification • Biopsychosocial History • Decision Tree/History and data gathering • Rapport • Diagnoses and Feedback • Techniques • Prognosis & Plan • Difficult Patients • Differential Diagnosis • Chapter 1

  8. Clinical Examination • Mental Status Examination Appearance; Attitude toward Examiner; Speech Characteristics; Psychomotor; Mood; Affect; Perception; Thought Process; Thought Content; Sensorium & Cognition; Concentration & Attention; Reading and Writing; Visuospatial Ability; Abstract Thought; Information & Intelligence; Judgment & Insight • Chapter 1

  9. Assessment • Psychiatric Disorder • RoS • Physical Exam • Nature of the Complaint • Adverse Reactions • Medical Referrals from Psychiatrists

  10. Laboratory Tests • Neuroendocrine • Thyroid; Cortisol Suppression; Kidney and Liver function • Blood Tests • STDs • Psychotropic Medications • Lithium but not most • Provocation of Panic Attacks • Sodium Lactate (72%) • Lumbar Puncture • Cognitive Changes due to CNS Infection • Substance Abuse • Random or purposeful

  11. Typical Signs & Symptoms in Psychiatric Illness • Consciousness • Emotion • Motor behavior • Thinking • Speech • Perception • Memory • Intelligence • Chapter 3

  12. Classification Systems • ICD-10 • DSM-IV • Axis I - Clinical Disorders • Axis II - Personality Disorders • Axis III - General Medical Conditions • Axis IV - Psychosocial Stressors • Axis V - GAF • Chapter 5

  13. Global Assessment Functioning • Most commonly used with DSMIV (Axis V) • Clinician’s Judgment of patient’s overall level of functioning (100-0)

  14. Mental Health Stats • 30% of population has a diagnosable mental disorder (2008 Surgeon General) • $300 Billion annual cost of untreated mental illness. (NIMH 2006) • $30 Billion a year in absenteeism and poor work performance (MIT 2006) • No federal law that requires employers to provide adequate health insurance for mental health (2001) • 2002 Labor HHS Education appropriations bill called for parity. Passed in 2008 but has not implemented for the most part. • 2009 – US Citizens continue to experience decrease in health and mental health coverage

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