Psychiatric Services - SPMM High Yield: Q’s And A’s
Proportion of Europeans with mental health issues in past year that attended
GPs? Right Ans - 33%
Which study estimated the differences in incidence of psychosis in different
ethnic groups in the UK? Right Ans - AESOP Study (Aetiology and Ethnicity
in SCZ and Other Psychoses) Study. 10 year case-control trying to identify
social/biological factors accounting for increased SCZ in African-Caribbean
population.
Also found higher prevalence of Bipolar in African-Carribbean.
How does transcranial magnetic stimulation work? What is it for? Right
Ans - Generates focal seizure by stimulating cortical neurones- Faradays
electromagnetic induction.
Single pulse- Migraine
Repeated pulse - Treatment resistant depression (FDA, NNT 4)
What is TMS used for? Right Ans - TRD, 40% response that lasts >6
months. Applied to DLPFC for 30mins/day for 4 weeks. No recovery period,
minimal amnesia.
Can cause seizures if applied to motor area, reduce AH if Wernickes.
To either increase activity in dominant hemisphere or reduce activity in non-
dominant.
What did Moniz develop? Right Ans - The procedure of pre-frontal
lobotomy after a single report of its sue on a chimp.
How are psychosurgeries performed? Right Ans - Radio frequency
thermocoagulation or gamma knife.
What is the subcaudate tractotomy used for? Right Ans - Mood disorder-
63% remission
What is a limbic leukotomy and anterior capsulotomy used for? Right Ans -
OCD- 58% improvement
, What are the side effects of psychosurgery? Right Ans - Older techniques-
personality 60%, epilepsy 15%, amotivation 4%
Newer techniques- headache/nausea/weight gain. No cognitive impairment.
Where is the DBS placed for Parkinson's? Right Ans - Subthalamic nucleus,
internal global pallidus
Where is the DBS placed for OCD? Right Ans - Internal capsule
What are the main side effects of DBS? Right Ans - Infection (<15%),
haemorrhage, CVA, depression
Why/how is vagus nerve stimulation performed? Right Ans - Left cervical
vagus nerve
Treatment resistant partial onset epilepsy
What did Sainsbury's talk about? Right Ans - MDT key competencies
What did Moss talk about? Right Ans - Moss= MDT key functions; proactive,
continuing care, increased access, organised response.
What are the benefits of an MDT? Right Ans - Increased efficacy, increased
engagement post d/c, increased continuity of care, cost effective, reduced bed
use, reduced prolonged referrals.
What did the National Service Framework (1999) set out? Right Ans -
SERVICING community.
7 standards for community psychiatry (increased promotion, primary care
crisis response, support carers, reduce suicide rates)
NHS plan 2000= intensive community care teams (EI, crisis)
What did the New mental health strategy for England set out in 2011?
Right Ans - New concept= Good mental health for all.
Proportion of Europeans with mental health issues in past year that attended
GPs? Right Ans - 33%
Which study estimated the differences in incidence of psychosis in different
ethnic groups in the UK? Right Ans - AESOP Study (Aetiology and Ethnicity
in SCZ and Other Psychoses) Study. 10 year case-control trying to identify
social/biological factors accounting for increased SCZ in African-Caribbean
population.
Also found higher prevalence of Bipolar in African-Carribbean.
How does transcranial magnetic stimulation work? What is it for? Right
Ans - Generates focal seizure by stimulating cortical neurones- Faradays
electromagnetic induction.
Single pulse- Migraine
Repeated pulse - Treatment resistant depression (FDA, NNT 4)
What is TMS used for? Right Ans - TRD, 40% response that lasts >6
months. Applied to DLPFC for 30mins/day for 4 weeks. No recovery period,
minimal amnesia.
Can cause seizures if applied to motor area, reduce AH if Wernickes.
To either increase activity in dominant hemisphere or reduce activity in non-
dominant.
What did Moniz develop? Right Ans - The procedure of pre-frontal
lobotomy after a single report of its sue on a chimp.
How are psychosurgeries performed? Right Ans - Radio frequency
thermocoagulation or gamma knife.
What is the subcaudate tractotomy used for? Right Ans - Mood disorder-
63% remission
What is a limbic leukotomy and anterior capsulotomy used for? Right Ans -
OCD- 58% improvement
, What are the side effects of psychosurgery? Right Ans - Older techniques-
personality 60%, epilepsy 15%, amotivation 4%
Newer techniques- headache/nausea/weight gain. No cognitive impairment.
Where is the DBS placed for Parkinson's? Right Ans - Subthalamic nucleus,
internal global pallidus
Where is the DBS placed for OCD? Right Ans - Internal capsule
What are the main side effects of DBS? Right Ans - Infection (<15%),
haemorrhage, CVA, depression
Why/how is vagus nerve stimulation performed? Right Ans - Left cervical
vagus nerve
Treatment resistant partial onset epilepsy
What did Sainsbury's talk about? Right Ans - MDT key competencies
What did Moss talk about? Right Ans - Moss= MDT key functions; proactive,
continuing care, increased access, organised response.
What are the benefits of an MDT? Right Ans - Increased efficacy, increased
engagement post d/c, increased continuity of care, cost effective, reduced bed
use, reduced prolonged referrals.
What did the National Service Framework (1999) set out? Right Ans -
SERVICING community.
7 standards for community psychiatry (increased promotion, primary care
crisis response, support carers, reduce suicide rates)
NHS plan 2000= intensive community care teams (EI, crisis)
What did the New mental health strategy for England set out in 2011?
Right Ans - New concept= Good mental health for all.
