PSYCHIATRY IN NEUROSCIENCE BLOCK FALL 2009
GROUP SCHEDULE
PSYCHIATRY LECTURES (revised June 30, 2009)
1
GROUPS: (8-9 students with 2 faculty members) will meet EIGHT times during the
Neuroscience Block. Just as in the CVPR Block, you will interview volunteer patients, practice the
assessment interview, utilize psychiatric screens, and complete PATIENT INTERVIEW
REVIEWS after each interview.
GENERAL GROUP GOALS
1. Practice and learn to utilize THE THERAPEUTIC 4-PART ASSESSMENT as you interview
patients during these eight sessions.
2. Practice and learn to utilize appropriate screens from the CU MEDICAL STUDENT
ASSESSMENT OF COMMON PSYCHIATRIC PROBLEMS which you should bring to all of
the interviews
3. Complete PATIENT INTERVIEW REVIEWS after each patient session
Reading:
o
Text: BLUEPRINTS PSYCHIATRY 5TH Edition (2009). Lippincott, Williams and
Wilkins
o
and HANDOUTS
Mini-lectures and Small Groups
10:00-10:25 am – Mini-lecture in Education 1 (Bldg P26), Room 1500 (group leaders are
invited to attend)
10:30 am-Noon – Small groups meet in Education 1 (see attached schedule for room
numbers). You will be in the same rooms you had for the CVPR Block. Discuss previous week’s
INTERVIEW REVIEWS UNTIL 10:50. Interview new patient UNTIL 11:40 followed by wrap-up.
Week 1: Wed. 8/19/09 Post-Traumatic Stress Disorder: The changed brain
Mini-lecture: Weissberg
Read: PTSD Handout + Blueprints Chapter 3, a review of anxiety disorders and
specifically the section on PTSD and Acute Stress Disorder. You also may want to
scan Chapter 12 (antidepressants which could just as well be called anti-anxiety
agents) for your patient interview.
(For your reading pleasure, I have also included handouts on the history of
psychiatry, definitions, and an article by Eric Kandel and his principles of
neuroscience)
Group: Interview patient with PTSD, use appropriate screens, and generate
INTERVIEW REVIEWS.
Week 2: Wed. 8/26/09 Autism and Normal Development
Mini-lecture: Hepburn
1. Normal and abnormal psycho-social development
Read: Handout + Blueprints Chapter 7, Disorders of Childhood and Adolescence.
Chapter 17, Psychological Theories, pp 107-108 and table17-2 on p 109
Group: Interview autistic person and/or their family. Use appropriate screens and
generate INTERVIEW REVIEWS.
PSYCHIATRY IN NEUROSCIENCE BLOCK FALL 2009
GROUP SCHEDULE
PSYCHIATRY LECTURES (revised June 30, 2009)
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Week 3: Wed. 9/2/09 Delirium/Dementia
Mini-lecture: Hal Wortzel
1. Behavioral Neurology and the MSE
Read: Handout + Blueprints Chapter 8, Cognitive Disorders
Group: Interview patient with a cognitive disorder and/or their family. Utilize
appropriate screens and generate INTERVIEW REVIEWS.
Week 4: Wed. 9/9/09 Somatic Complaints and Pain
Mini-lecture: Weissberg
1. Idiopathic somatic complaints: psychosocial distress, somatoform disorders & the
differential diagnosis of the somatic complaint
Read: Handout + Blueprints Chapter 9, Somatoform Disorders, pp 64-65, and
Factitious Disorders on p 69
Interest only: Health Anxiety in Medical Students (Lancet Vol. 351, 5/2/1998)
Munchausen’s Syndrome (Lancet Vol. 359, 1/26/2002)
Group: Interview patient with chronic pain. Utilize appropriate screens and generate
INTERVIEW REVIEWS.
Week 5: Wed. 9/16/09 Movement Disorders
Mini-lecture: Weissberg
Read: MOVEMENT DISORDERS: Sorting out neurological & pseudoneurological disease and the problem of “medical clearance”. Or, the last
person to see the patient gets to make the last mistake.
Live and Let Live in THE MEDICAL DETECTIVES, Burton Roueche originally published
in The New Yorker And, if you want to, Weissberg M: Emergency Room Medical
Clearance: An Educational Problem. Am J Psychiatry, 136 (6) 787-90, June 1979
Group: Interview patient with a movement disorder. Utilize appropriate screens and
generate INTERVIEW REVIEWS.
Week 6: Wed. 9/23/09 Psychiatry patient (Schizophrenia/Bipolar Illness)
Mini-lecture: Bob Freedman: Psychosis + Schizophrenia
Read: Handout + Blueprints Chapter 1, Psychotic Disorders, Chapter 2,
Mood Disorders
Group: Interview patient. Utilize appropriate screens and generate INTERVIEW
REVIEWS.
PSYCHIATRY IN NEUROSCIENCE BLOCK FALL 2009
GROUP SCHEDULE
PSYCHIATRY LECTURES (revised June 30, 2009)
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Week 7: Wed. 9/30/09 Psychiatry patient
Mini-lecture: Freedman
Read: Handout + Blueprints Chapter 11, Anti-Psychotics and Chapter 13, Mood
Stabilizers
Group: Interview schizophrenic or bipolar patient. Utilize appropriate screens and
generate INTERVIEW REVIEWS.
Week 8: Wed. 10/7/09 Substance Use Disorders
Mini-lecture. Alcoholics Anonymous
Read: Handout + Blueprints, Chapter 5, Substance Related Disorders
Group: Interview AA volunteer. Utilize appropriate screens – including CAGE – and
generate INTERVIEW REVIEWS.
FULL PSYCHIATRY LECTURES IN NEUROSCIENCE BLOCK
8/26
9:00-10:30
Developmental Disorders: Hepburn
Read: Handout + Blueprints readings above
9/24
8:00–9:00
Physiology of Sleep: Weissberg
9:00-10:00
Treatment of Sleep Disorders: Weissberg/French
Read: Handout + Blueprints, Chapter 9, Sleep, pp 67-69
9/28
11:00-noon
ADHD: Ross
Read: Handout & review Blueprints, Chapter 7
9/29
8:00–9:00
Anxiety Disorders: Davies
Read: Handout + Blueprints, Chapter 3, Anxiety Disorders, Chapter 14, Anxiolytics,
Chapter 17, Psychological Theory & Psychotherapy, pp 108-111, Cognitive Theory
through Dialectical Behavioral Therapy
10:00-11:00 Mood Disorders: Schneck
Read: Handout + Blueprints, Review Chapters 2, 12, 13 (Mood Disorders,
Antidepressants & Somatic Therapies, Mood Stabilizers,)
11:00-Noon
Antidepressants & Mood Stabilizers: Freedman
Read: Handout + Blueprints Chapter 12, Antidepressants pp 80-85; Chapter 13, Mood
Stabilizers, pp. 87-91
9/30 8:00–9:30
9:30-10:30
Anti-Psychotic Agents: Freedman
Psychotic Disorders: Freedman
Read: Handout + review Chapter 1, 11 and read Chapter 16, Major Drug Adverse
Reactions
10/2
8:00-9:50
Addiction I & II: Crowley
Read: Handout + Blueprints, Chapter 5, Substance-Related Disorders
PSYCHIATRY IN NEUROSCIENCE BLOCK FALL 2009
GROUP SCHEDULE
PSYCHIATRY LECTURES (revised June 30, 2009)
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PATIENT INTERVIEW REVIEWS
Each student completes a brief PATIENT INTERVIEW REVIEW based on each group interview,
turns it in to their leaders (or Sharon Campbell after the last group) and is ready to discuss the
interview, briefly, the following week before the next patient interview. A copy of the form
is in this booklet, posted on Blackboard, and Sharon Campbell will have forms available each
interview morning. Reviews are graded on a Pass/Fail basis.
The format looks like this:
PATIENT INTERVIEW REVIEW
When examining patients, EIGHT QUESTIONS lead to eight potential areas of inquiry. You will have to decide which
are relevant for your patient now. If pressed for time, deal with why now, medical illness, lethality; the others can
wait. If you suspect a medical cause for altered thinking, feeling and behavior, do a MSE, PE and history first.
1.
2.
3.
4.
5.
6.
7.
8.
Why is the patient here now and not last week or next?
What does the patient want/expect from you or this interview?
Are medical problems causing the patient's difficulties with mood, thinking, or behavior? The MSE, history, & PE
will be helpful here. Deficits in memory (dementia) or waxing/waning level of attention (delirium) point to
cognitive disorders.
Is this situation potentially lethal (suicide, homicide, and child/spouse abuse)?
Are families and/or friends part of the problem or part of the solution?
What are the patient's cultural expectations, explanations, & treatments for their illness?
Is there a psychiatric diagnosis? Draw a family tree with the patient if the diagnosis remains unclear. This
also may help with your cultural understanding of the patient.
What are the patient’s repetitive life themes, characteristic ways of dealing with stress & people
(including you) i.e. how does their personality style contribute to their current situation.
Interview process and tasks
1. Invite & Engage the patient
and invite, listen, summarize
4. Set goals, plan intervention, ↑↑
adaptive responses ***
***if this is your patient
2. Assess the relevant eight
questions & use appropriate screens
3. Narrow focus to patient’s most
troubling current problem, their affect, and
how they are dealing with their dilemma.
Adaptive? Maladaptive?
Comment on the following:
1. Brief patient description
2. What went well in the process of this interview e.g. What did the interviewer(s) do to help engage
the patient?
3. Which of the eight areas were explored? Would you want to explore other areas? Why?
4. What is the patient’s current main concern(s) and affect about this concern? Is the patient
responding to this issue in adaptive or maladaptive ways? Give examples if you can.
5. If this were your patient, what would be the focus of your current treatment? If you suggest a
pharmacologic intervention, briefly outline the medicine’s purported modes of action (e.g. neurotransmitters, possible sites of action) and one or two major side-effects.
6. Any other observations or comments?
PSYCHIATRY IN NEUROSCIENCE BLOCK FALL 2009
GROUP SCHEDULE
PSYCHIATRY LECTURES (revised June 30, 2009)
5
Keys to a successful group:
 A commitment to express your ideas in collegial ways. An effective group depends on your
contribution so please, please speak up.

Understanding should always be thought of as spanning the molecular to the big picture.
This is how you will practice medicine for the rest of your career.

You and your leaders will evaluate how your group is functioning. This includes whether your
group has slipped into a “hub and spoke” teaching mode with your leaders assuming their
traditional roles as the source of all knowledge and students becoming passive listeners.
Evaluations (see attached forms)
You will evaluate your group experience at the end of these eight sessions. Your leaders will not
see your evaluations until after they have completed theirs. The purpose of these evaluations is
to see what went well and to improve student and group leader functioning, if needed.