Psychiatry
Psychiatry tests mental state examination, risk assessment, common disorders, psychopharmacology, and safe consent. High-yield areas are depression, psychosis, bipolar disorder, anxiety, suicide risk, and medication emergencies.
Core rules
- Mental state examination covers appearance, behaviour, speech, mood, affect, thought, perception, cognition, and insight.
- Suicide risk: ask directly, assess plan, means, intent, previous attempts, and protective factors.
- Depression: core symptoms plus duration and functional impairment; screen for bipolar disorder before antidepressants.
- Psychosis: assess hallucinations, delusions, disorganisation, and organic causes.
- Serotonin syndrome and neuroleptic malignant syndrome are emergencies requiring medication review and supportive care.
Worked example
A 30-year-old man says life is not worth living and has stockpiled tablets. The reasoning is: active suicidal ideation with plan and means is high risk. Ask directly about intent, remove means, arrange urgent psychiatric assessment, and do not leave him alone. Document the risk assessment and safety plan.
Traps that cost marks
- Avoiding the word “suicide” because of discomfort.
- Starting an antidepressant in unrecognised bipolar disorder.
- Missing organic causes such as delirium or thyrotoxicosis.
- Ignoring metabolic and autonomic signs of serotonin syndrome.
- Assuming capacity is absent just because a patient is agitated.