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EIS from a trainee’s perspective. Adam Joiner ST-5. What I have learnt. Way of working Assessment Diagnosis Management Patients. Way of working. Small case loads Time Diagnostic uncertainty. Assessment. At-risk mental state Established mental states Who gets referred. Diagnosis.
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EIS from a trainee’s perspective Adam Joiner ST-5
What I have learnt • Way of working • Assessment • Diagnosis • Management • Patients
Way of working • Small case loads • Time • Diagnostic uncertainty
Assessment • At-risk mental state • Established mental states • Who gets referred
Diagnosis • Identifying psychosis • Identifying absence of psychosis: • OCD • Personality disorder • Co-morbidities and psychosocial problems • F62 • ASD • ARMS
F62.0 Enduring personality change after catastrophic experience “Enduring personality change, present for at least two years, following exposure to catastrophic stress. The stress must be so extreme that it is not necessary to consider personal vulnerability in order to explain its profound effect on the personality. The disorder is characterized by a hostile or distrustful attitude toward the world, social withdrawal, feelings of emptiness or hopelessness, a chronic feeling of "being on edge" as if constantly threatened, and estrangement. Post-traumatic stress disorder (F43.1) may precede this type of personality change.”
Management • Pharmacological • Psychological • Social
Patients • Hope and recovery
Critique of EIS • Over-inclusive • Over-investment in psychosis • Risk of medicalising normal phenomena • Risk of normalising medical phenomena