The George Washington University Medical Center
School of Medicine and Health Sciences
PCHI 30150: Psychopathology and Conceptual Models
Course Meeting Dates and Times:
Course Director:
Mondays
Thursdays
1-2
1:30-4
Name: Charles P. Samenow, MD, MPH
Email: csamenow@mfa.gwu.edu
Course Coordinator: Name: Shaira Morales
Email: smorales@mfa.gwu.edu
Room: 201/101
Phone: 202-741-2875
Office Hours: TBD
Phone: 202-741-2871
Course Overview:
The purpose of this course is to introduce students to the biological, psychological and social
determinants of abnormal human behavior. The course will use in-class lectures, readings, small
group exercises, video vignettes and live-patient interviews. By the end of the course, you
should be able to identify and state the epidemiology, symptomatology, course, genetic and
environmental determinants and treatment options for the major psychiatric disorders. You will
also be expected to identify and apply the theoretical and clinical concepts in the evaluation and
initial treatment of the psychiatric patient and present that formulation in a standard medical
write-up form.
The material covered includes 1) psychiatric interviewing and the biopsychosocial formulation,
2) biological, psychological and social determinants of behaviors, 3) the major clinical
psychiatric disorders, and 4) an introduction to somatic and psychosocial treatments.
Curriculum Interface:
This course contributes to the following curriculum objectives:
Medical Knowledge:

Apply the scientific basis of the normal structure, development, function, and
relationships among the major organ systems of the body to concepts of health and disease.

Link biochemical, physiological, neurological, and immunological mechanisms to their
role in maintaining body homeostasis.

Apply principles of pathophysiology to diseases and disorders.

Compare and contrast the genetic processes and environmental influences on health and
on disease and its treatment.

Interpret the role of normal human biological, cognitive, psychological, and behavioral
development across the life span as determinants of health and illness.

Interpret the clinical, laboratory, pathologic, and radiologic manifestations of common
diseases in patient care


Apply pharmacological principles to medical therapeutics.
Apply the principles of epidemiology to the practice of medicine for the individual and
the local and global communities.
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Patient Care:

Elicit a complete and accurate patient history including belief systems, spiritual and
cultural issues and incorporate these into the comprehensive care of a patient.

Perform an accurate and relevant screening and focused physical and mental status
examinations.

Select appropriate physical examination techniques, laboratory tests, radiologic, and
other clinical studies and interpret the results.


Formulate a plan for the diagnosis and treatment of common medical conditions.
Identify opportunities for early intervention, prevention, and health education taking
into account barriers to change.
Interpersonal and Communication Skills:

Demonstrate empathic patient-centered communication.

Synthesize and present a coherent description of the patient s clinical condition based
upon the information obtained from the patient and other resources.

Consider the patient's culture, beliefs and level of health literacy in communicating
effectively.
Practice Based Learning and Improvement:

Apply reflection and feedback to incorporate lessons learned into future practice.

Utilize electronic and other resources in the practice of life-long learning.

Apply medical standards, clinical practice guidelines, and practice algorithms
appropriately for individual patients or populations.
Systems Based Practice:

Discuss the role of advocacy and healthcare policy in improving patient care.

Use system resources available to patients and communities for health education,
treatment, and rehabilitation of medical and psychiatric conditions.

Define the elements in the healthcare system that lead to disparities in health and access
to healthcare.

Explain how diverse cultures and belief systems impact perception of health and illness
and response to symptoms, diseases, and diagnostic and treatment interventions.
Professionalism:

Demonstrate ethical behavior including: Compassionate treatment of patients, Respect
for privacy and dignity, Honesty and integrity, Truthfulness, Patient Advocacy,
Confidentiality, Accountability
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Course Learning Objectives:
By the end of this course, each student should be able to:
1. Identify the epidemiology, symptomatology, course, causality (including genetic risk)
and treatment options for the major DSM-IV psychiatric disorders.
2. Demonstrate the major elements of a psychiatric interview, mental status exam, and
psychiatric write-up
3. Construct a psychiatric diagnosis based upon patient data including the patient history,
symptom presentation, mental status exam, laboratory data, and collateral information.
4. Formulate a psychiatric diagnosis using the biospychosocial model.
5. Recognize neuroanatomic structures and functional interconnections (circuits) to
behavioral symptom presentation, emotional regulation and syndrome management.
6. Apply major psychosocial theories to psychiatric illness and treatments.
7. Distinguish common mental disorders from each other and from normal human behavior.
Required Materials:
Primary:
Campbell and Rohrbaugh (2006). The Biopsychosocial Fomulation Manual. New York:
Routledge.
Andreasen and Black (2011). Introductory Textbook of Psychiatry. Arlington, VA: APPI
Secondary:
Sahler and Carr (2007) The Behavioral Sciences and Healthcare Cambridge, MA: Hogrefe.
Note: In some cases the Sahler text is recommended to supplement the primary readings.
The section on psychopathology is not in sufficient detail for this course and should only
be used for review purposes.
Recommended (Optional) Material:
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental
Disorders. (4th edition – Text Revision; DSMIV-TR). Washington, DC: Author.*
* Available Online
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Course Requirements, Deadlines, and Grading Values:
ASSIGNMENT
POINTS
1. Exam I
45
2. Exam II
45
DUE
3. Online Learning Modules
P/F
You will complete several online modules that include a patient video with an
accompanying written exercise. These modules form the building blocks to the full
patient interview and write-up that you will complete by the end of the course.
4. Small Groups
Attendance is mandatory for all small groups. Two small groups occur during normal
class time. Two additional small groups occur in the evening when you will accompany
your group leader into the hospital to interact with psychiatric patients. Any absences
must be approved by the course director prior to the small group. You will be graded on
your attendance and participation in your small groups.
Attendance
Participation
Psychiatric Write-Up
Differential Diagnosis/Treatment
10
10
20
20
5. On-line Practice Questions
P/F
Each “block” will have a series of board style questions for students to use as a review of
material and for preparation for the exam. Questions can be found on blackboard.
6. Psychiatric Selectives
P/F (and extra credit)
See Below
7. Patient Write-Up
50
Please use the model history and physical templates provided to you during lecture, small
groups and the Biopscyhosocial Fomulation Manual.
8. Final Exam
TOTAL:
100
300
Grading:
Honors: 270-300
Pass: 225 - 269
Conditional: 210-224
Fail: < 210
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Psychiatric Selectives and Honors Grade:
To receive honors, students must attend one film, panel discussion and/or observation during the
course and write a 1-page reflection on their experience. Schedule of films and guidelines for
the reflection will be posted on blackboard and distributed in class.
DATE
ACTIVITY
Film TBD
One-Woman Show
12 Step Observation
Observation of Rounds
Psychiatric Nursing Observation
Psychiatric Social Work Observation
Psychiatric Emergency Room
Honor Code:
All examinations, papers, and other graded work products and assignments are to be completed
in conformance with the George Washington University School of Medicine and Health Sciences
Honor Code.
Confidentiality of patients, particularly psychiatric patients, is of the highest importance. Any
patient information obtained through hospital observations, patient write-ups, attending clinical
settings should be highly protected. First names only or initials should be used on all
assignments. At no time should information be shared with others for purposes outside of
learning and/or clinical care.
Your Wellness and Mental Health:
Medical school can be hazardous to your health. We demand a lot of you. You expect a lot of
yourself. Make sure to take time during the semester for friends and fun. Take breaks from
studying. Explore Washington. Visit home. The study of psychiatry can be particularly
demanding. Often times, students suffer from or are close to those who suffer from the illnesses
that we will study. More often, students read about a disorder and believe that it applies to them.
Remember, we all have elements of many of the disorders which wax and wane over time. If
you feel overwhelmed, have concerns about yourself or others, please reach out.
It is unethical for any faculty member to provide psychiatric treatment to you. But, we are
happy to refer you to others who can. You may contact any lecturer on this list for a referral and
there is no expectation that you share why you need that referral. Alternatively, the Student
Health Services ((202) 994-6827) and University Counseling Services ((202) 994-5300) are there
for you as well. Finally, the Dean’s office also has an extensive network of mental health
providers.
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Class Schedule – Will meet in Ross 201 unless otherwise indicated
Date
Thurs 1/5
1:30 – 3:30
Mon 1/9
3:00-4:00
(Room 101)
Thurs 1/12
1:30 – 2:30
Thurs 1/12
2:30 – 4:00
Mon 1/16
Thurs 1/19
1:30-2:30
Thurs 1/19
2:40 – 3:40
Mon 1/23
1:00 – 2:00
(Room 101)
Thurs 1/26
1:30 – 4:00
Topic
Course Overview:
The Biopsychosocial
Model
Psychiatric
Interviewing and
Mental Status Exam
Building a Psychiatric
Diagnosis
Small Group #1: Intro
and Mental Status
Exam
NO CLASS
Depressive Disorders
and Suicide Risk
Assessment
Lecturer
Samenow
Readings
BFM: 1 - 12
Samenow
ITP: 16 – 55
Samenow
ITP: 3 -14
BFM 13-19
Adjustment Disorders,
Bereavement and
Demoralization
Mania and Bipolar
Disorders
Akman
Lieberman
ITP: Review
141-163
CASE STUDIES:
Depression and Suicide
Samenow
ITP: 389-398
Sahler: 183 188
Due
Reflection Due
Lieberman
ITP: 141 –
163
BFM: 54-59,
75-84
ITP: 359-368
Mon 1/30
1:00 – 2:00
TBD
Thurs 2/2
1:30 – 4:00
Mon 2/6
1:00-2:00
CASE STUDIES:
Anxiety Disorders
PEER REVIEW: MSE
AND SUICIDE RISK
ASSESSMENT
Frank/Samenow
Thurs 2/9
12:00-2:00
Stress Response, PTSD
and Dissociative
Disorders
Griffith
ITP: 197 –
205, 225-235
Sahler: 55-62
Mon 2/13
1:00 – 2:00
Tues 2/14
1:30 – 3:30
Thurs 2/16
9:00 – 11:00
(Room 101)
Psychosis
Afkhami
ITP: 107 –
139
Review: Putting it All
Together
EXAM #1
Samenow
Mental Status/
Suicide Risk
Write Up
Due
ITP: 169 –
197
Samenow
Mental Status/
Suicide Risk
Peer Review
Due
6
Thurs 2/16
11:00-12:00
(Room 101)
Mon 2/20
Thurs 2/23
1:30 – 4:00
Review Exam #1
Samenow
NO CLASS
Alcohol and Substance
Related Disorders
President’s Day
Samenow
Mon 2/27
1:00 – 2:00
Somatoform Disorders
Catapano
Thurs 3/1
1:30 – 4:00
CASE STUDIES:
Delirium, Dementia
and Secondary
Syndromes
Women’s Mental
Health
CASE STUDIES:
Personality Disorders
Samenow/Norris/
Trinidad
SPRING BREAK
TBD
Mon 3/5
1:00 – 2:00
Thurs 3/8
1:30 – 4:00
3/12 – 3/17
Mon 3/19
1:00 – 2:00
Wed 3/21
9:00 – 11:00
Mon 3/26
1:00 – 2:00
(Room 101)
Tues 3/27
1:30 – 4:00
Fri 3/30
9:00 – 12:00
Mon 4/2
1:00 – 2:00
Thurs 4/5
1:30 – 4:00
Mon 4/9
1:00 – 2:00
Thurs 4/12
1:30 – 4:00
Mon 4/16
1:00 – 2:00
Thurs 4/19
1:30 – 3:30
Mon 4/23
1:00 – 2:00
ITP: 241-283
Sahler: 40-44,
63-71
BFM: 59-61
ITP: 207-220,
235-239
ITP: 83 – 105
Frank
SPRING BREAK
ITP: 285 –
317
BFM: 40 - 53
SPRING
Biopsychosocial
Formulation
Due
BREAK
PEER REVIEW:
Biopsychosocial
Formulation
Sleep Disorders
Samenow
BFM: 63-70
Biopsychosocial
Formulation
Peer Review
Jain
ITP: 443-464
REVIEW: Putting it all
together
EXAM #2 AND
REVIEW
Gender Identity
Samenow
Akman/Samenow
Moved to Human
Sexuality
Samenow/Houston
(Turning Point:
Bring Clickers)
CASE STUDIES:
Child Development and
Psychopathology
ADD and
Robb
Psychostimulants
Sexual Disorders and
Samenow
Paraphilias
Sexual Dysfunctions
Catapano
ITP: 399 –
420, 428-441
CASE STUDIES:
Eating Disorders and
Adolescence
No Class
ITP: 343 –
357
Samenow
ITP: 420-428
ITP: 330-338
ITP: 321-330
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Thurs 4/26
1:30 – 2:30
Introduction to
Psychopharmacology
Thurs 4/26
2:30 – 4:00
SMALL GROUP:
Establishing a
Diagnosis
Complementary and
Alternative Practice in
Psychiatry
In-Class Patient
Interview and
Discussion
ECT and Emerging
Therapies
Psychotherapy and
Social Interventions
Small Group #3:
Psychotherapy and
Wrap-Up
Review: Putting It All
Together
EXAM #3
Mon 4/30
1:00 – 2:00
Thurs 5/3
1:30 – 4:00
(Room 101)
Mon 5/7
1:00 – 2:00
Thurs 5/10
1:30 - 2:30
Thurs 5/10
2:30 – 4:00
TBD
Wed 5/16
9:00-11:00
(Room 101)
Wed 5/16
11:00-12:00
(Room 101)
Review of Exam #3
Samenow
ITP: 512 –
530; 538 –
543
Kogan
TBD
Samenow
BFM: 111130
Samenow
ITP:546-551
Samenow/Frank
ITP: 477 –
499
White Coat
Required
Live Patient
Interview Due
Samenow
(Turning Point:
Bring Clickers)
Samenow
All classes are in Room 201, unless otherwise noted
BFM = Biopsychosocial Formulation Manual
ITP = Introductory Textbook of Psychiatry
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