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South West Peninsula MRCPsych Course HISTORY OF PSYCHIATRY Friday 17/9/10 Timetable 10:00 am: History of Psychiatry 11:30 am: Coffee Break 11:45 am-12:45 pm: Film documentary on History of Psychiatry “Shell-shock syndrome” 1:30 pm-2:30pm : Overview of Core Psychiatry Training in SWP. -MRCPsych Examinations (Paper 1, 2, 3 and CASC) -WPBA -Electronic Portfolio -ARCP THANK YOU Brief Information on Paper 1 of the MRCPsych General Adult History and mental state examination Cognitive assessment Neurological examination Assessment Aetiology Diagnosis Classification Basic Psychopharmacology Basic psychological processes Human psychological development Social psychology Description and measurement Basic psychological treatments Prevention of psychiatric disorder Descriptive psychopathology Dynamic psychopathology **History of psychiatry** Basic ethics and philosophy of psychiatry Stigma and culture Paper 1 The MRCPsych Paper 1 will be 3 hours long, containing 200 questions. The paper will include both ‘best answer 1 of 5’ style MCQs and EMIs. Approximately one third of the paper will be the EMI component. Recommended Bibliography Hilgard’s Introduction to Psychology By Rita Atkinson et al Symptoms in the Mind by Andrew Sims (Psychopathology) Fish’s Psychopathology: Sings and Symptoms in Psychiatry by Casey & Kelly Medical Ethics by Alastair Campbell et al Psychiatric Ethic by Sydney Block Every family in the land: understanding prejudice and discrimination against people with mental illness. (Arthur Crisp) Sociology as applied to medicine, Graham Sandler Revision Notes in Psychiatry, Basant Oxford Handbook of Psychiatry (David Semple) Resources for Paper 1 MRCPsych revision www.trickcyclists.co.uk (Free site, allows you access to true false questions) www.mrcpsych.com (free but not updated to new format) www.xamcram.com (free but you have to sign on) Online and Weekend / classroom revision courses Super Ego Café Course The Manchester Course The Birmingham Course The Oxford Course SPMM course The Cambridge Course South West Peninsula MRCPsych Course HISTORY OF PSYCHIATRY Ancient Treatments of “Mental Illness” 10 000 BC onwards : Trepanation 15 00 BC Ebers Pyparus (Egyptians): Described illness like Dementia Depression and Schizophrenia. 14 00 BC Atharva Veda (ancient Indian test) 1000 BC The Yellow Emperor Classic of Internal Medicine. 450 BC Hippocratic Test: Moved a way from supernatural to rational explanation of causation (quoted depression, mania, hysteria and dementia) 280 BC Theophrastus: 28 types of personalities or temperaments 270 BC First Psychiatric Hospital (Bagdad) 1247 Bethlam Hospital Funded (First Psych patient in 1930) today is part of SLAM Psychiatry Timeline 1637 Decartes “Discourse de la Methode” body is something different from the mind 1650—1950: The Asylum Era 1667 Thomas Willis 1792 Philippe Pinel (improving asylums and classifications). William Tuke took these Ideas to the UK York retreat. 1845 Lunacy Act in the Asylum Era, replacing private madhouse. 1852 Morel (France) makes referene to Dementia Praecox. 1863 Kahlbaum described hebephrenia 1869 Beard described Neuroasthenia 1895 Freud and Breuer published Studies on Hysteria 1899 Emil Kraepelin established nosology which dominate XIX century Psychiatry Timeline 1907 Alzheimer’s Eugene Bleuler’s group of scizophrenia Karl Jasper General Psychopathology 1914-1918 WW1 “Shell-shock Syndrome” 1880 Johann Christian Reil quoted the term Psychiatry. 1841 Association of Medical Officers for Asylums and Hospital for the insane 1866 Medical Psychological Associations 1971 became the RCPsych Asylum the Good Bad and Ugly POSITIVE NEGATIVE Public Safety Stagnant, cut off from the worl Food, Shelters and clothes Internal abuse, neglect scandals Diagnositic, Research, classifications Institutionalization Occupations activities Failure of Moral Therapy Recognition of Mental Illness Distant, stigmatization Financial social commitments Oversized, underfunded Publications on Psychiatry 1843 Annales Medico-psychologiques 1844 American Journal of Insanity 1848-1854 Journal of Psychological Medicine and mental pathology 1853 Asylum Journal 1858-1962 Journal of Mental Science 1963 British Journal of Psychiatry 1970 Psychological Medicine 1977 Psychiatric Bulletin (The Psychiatrists) 1808 Act for “Better Maintenance and Care of the Lunatic” 1844-45 Lunatics and Asylum Acts (Statutory duty to provide asylum) 1890 Lunacy Act 1913 Mental Deficiency Act- Board of control to supervise Asylum 1930 Mental Treatment Act- outpatients and involuntary admissions allowed 1959 Mental Health Act, ending of magistrate’s courts and board of control. Mental Health Tribunals introduced 1983 Mental Health Act-Introduced consent, Approved SW AND Mental Health Act Commission. 1995 Patients in the community act- Supervised Discharged 2007 Revised Mental Health Act (AMHP and Approved Clinicians) The Road to Modern Psychopharmacology 1855 Von Bibra 17 types of Mind altering plants 1955 Reserpine and Meprobamate 1884 Adrenaline Identified 1956 Methylphenidate 1898 Mescal 1957 Chlordiazepoxide 1901 Adrenaline marketed 57-60 TCA 1926 Henrry Dale 1959 Diazepam marketed 1929 Amphetamine 1974 Lab testing for Fluoxetine 1943 Hofmann’s LSD 1987 Fluoxetine 1950 Chlorpromazine 2WW 1WW Lunacy Acts 1890 Clunis Report Years Psychiatry History in the Cinema Witch finder General (1968 Michael Reeves) Freud (1962 John Huston) The Snake Pit (1948 Anatole Litav) One Flew over the Cuckoo’s nest (1975 Milos Forman) Family Life (1971 Ken Loach) Core Training WPBA minimum required per year from CT1-CT3 ACE 2 for CT1 and 3 for other CT mini-ACE 4 CbD 4 mini-PAT 2 SAPE 1 CBOGA 2 DONCS WPBA Recommended number per year CP 1 JCP 1 DOPS As the opportunity arises AoT A the opportunity arises WPBA Undertaken by ST1-3 trainees can be assessed by: ST4-6 trainees SpRs Associate Specialists Consultants Band 7 nurses or psychologists or the equivalent Portfolio Details of individual posts held including job plan, timetable, learning objectives, and progress towards achieving objectives Log or record of clinical activity (type and number of clinical contacts) Record of psychotherapy experience and supervision All workplace based assessments including observed clinical practice and any other clinical review data List of competencies relevant to ST level Audit reports/records Reflective notes (e.g. consideration of significant events) Record of teaching activity including feedback or other assessment data Records of clinical and educational supervision Declaration of interests Portfolio (continuation) Note of any health concerns Management activity (e.g. committee or project work) Research activity including supervision record, ethical committee application/approval, presentations, publications Record of posters and presentations (e.g. at College Divisional or Faculty meetings) Examinations taken and results Copies of important documents such as GMC registration, membership certificates Copies of NHS appraisal sign off Structured reports from supervisors and tutors