Transcript HistoryofPsychiatry-DrDelgado

South West Peninsula MRCPsych Course
HISTORY OF PSYCHIATRY
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
General Adult
History and mental state
examination
Cognitive assessment
Neurological examination
Assessment
Aetiology
Diagnosis
Classification
Basic Psychopharmacology

Basic psychological processes

Human psychological
development

Social psychology

Description and measurement

Basic psychological treatments

Prevention of psychiatric disorder

Descriptive psychopathology

Dynamic psychopathology
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**History of psychiatry**
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Basic ethics and philosophy of
psychiatry
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Stigma and culture
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
South West Peninsula MRCPsych Course
HISTORY OF PSYCHIATRY
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
NEGATIVE
Public 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
2WW
1WW
Lunacy Acts
1890
Clunis
Report
Years
Psychiatry History in the Cinema
 Witch finder General (1968 Michael
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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
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Log or record of clinical activity (type and number of clinical contacts)
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Record of psychotherapy experience and supervision
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All workplace based assessments including observed clinical practice and
any other clinical review data
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List of competencies relevant to ST level
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Audit reports/records
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Reflective notes (e.g. consideration of significant events)
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Record of teaching activity including feedback or other assessment data
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Records of clinical and educational supervision
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Declaration of interests
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Portfolio (continuation)
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Note of any health concerns
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Management activity (e.g. committee or project work)
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Research activity including supervision record, ethical committee
application/approval, presentations, publications
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Record of posters and presentations (e.g. at College Divisional or Faculty
meetings)
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Examinations taken and results
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Copies of important documents such as GMC registration, membership
certificates
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Copies of NHS appraisal sign off
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Structured reports from supervisors and tutors