HISTORY OF PSYCHIATRY South West Peninsula MRCPsych Course

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

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

General AdultHistory and mental state examinationCognitive assessmentNeurological examinationAssessmentAetiologyDiagnosisClassificationBasic Psychopharmacology

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

HISTORY OF PSYCHIATRY South West Peninsula MRCPsych Course

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 NEGATIVEPublic 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

Lunacy Acts 1890 Clunis

Report

Years

1WW

2WW

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