Depressive disorder – clinical presentation Case history 16 Sharon is a 26-year-old single woman who lives alone and works as a civil engineer. She is having problems at work as…

Mental state examination In psychiatry we are largely dependent upon the patient’s subjective account of symptoms in order to reach a diagnosis, with few opportunities to do objective diagnostic tests….

Epidemiology and aetiology of mood disorders Case history 14 Kwame has bipolar affective disorder. He asks you whether his adult children are likely to develop the condition and if there…

Epidemiology and aetiology of schizophrenia Much is known about the aetiology of schizophrenia but the exact nature of the condition is still unclear. One problem in researching this area is…

Depressive disorder – management The differential diagnosis of depressive episodes is shown in Figure 1. Physical causes of depression need to be excluded, through physical examination and, if indicated, physical…

History and aetiology The standard sections covered by the psychiatric history are shown in Figure 1. An important thing to note is how similar these are to those covered by…

Old age psychiatry I Dementia The prevalence of dementia rises sharply in old age, with 5% of people over 65 years and 20% of people over 80 years being affected….

Recovery and social inclusion The recovery model Mental illness can affect all aspects of the individual’s life, and that of those close to them. The personal journey of these individuals…

Acute and chronic schizophrenia Acute schizophrenia The first presentation of schizophrenia is usually with an acute episode, consisting of positive symptoms. In some cases, the patient has been well prior…

Family and social treatments Episodes of mental illness are often precipitated or prolonged by family and social problems. To make matters worse, family life and social function is often adversely…