Managements

Question 1

What are the main principles of psychotherapy

Answer 1

Develop therapeutic relationship

Listen to patient concerns

Empathetic approach

Provide information, support, and advice

Allow expression of emotions

Encourage self-help

Question 2

What is cognitive behavioural therapy

Answer 2

Aim to identify and challenge automatic negative beliefs, and then modify abnormal underlying core beliefs

Thinking errors

• Selective abstraction (focus on minor details)
• All or nothing thinking
• Magnification/minimisation
• Catastrophic thinking
• Overgeneralisation
• Arbitrary inference (conclusions in absence of evidence)

Question 3

What are the different types of behavioural therapy

Answer 3

Relaxation training

Systemic desensitisation
- Gradual exposure

Flooding
- Rapid exposure

Exposure and response prevention

Behavioural activation
- Make realistic plans, gradually increase activity

Question 4

What is psychodynamic psychotherapy

Answer 4

Aim to develop insight into maladaptive behaviour

Much longer duration than CBT

Indications

• Dissociative disorders
• Somatoform disorders
• Psychosexual disorders
• Some personality disorders
• Recurrent depression

Question 5

What is simple psychotherapy

Answer 5

Psychoeducation

Counselling

Supportive psychotherapy

Problem-solving therapy

Question 6

What are the new psychotherapies

Answer 6

Interpersonal therapy
- Focus on difficulties in relationships

Eye movement desensitisation and reprocessing
- Access traumatic memories, eventually resolve them

Cognitive analytic therapy
- Identify how problems begin in order to resolve them

Question 7

What is the seizure threshold in ECT

Answer 7

Minimum electrical stimulus needed to induce a seizure

Increased by
- Anaesthetic drugs anticonvulsants, benzodiazepines, barbiturates

Reduced by
- Antipsychotics, antidepressants, lithium

Question 8

What are the indications for ECT

Answer 8

Prolonged severe mania

Catatonia

Severe depression

• Treatment-resistant
• Serious risk to self/others
• Refusal to eat/drink

Question 9

What are the side effects of ECT

Answer 9

Short term

• Peripheral nerve palsies
• Cardiac arrhythmias
• Confusion
• Dental trauma
• Anaesthetic risk
• Muscle aches
• Headaches
• Short term memory loss
• Status epilepticus

Long term
- Anterograde and retrograde amnesia

Question 10

What are the contraindications for ECT

Answer 10

MI <3 months ago

Major unstable fracture

Cerebral aneurysm

Raised intracranial pressure

Stroke <1 month ago

History of status epilepticus

Severe anaesthetic risk