History of Psychiatry
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Transcript of History of Psychiatry
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HISTORY OF PSYCHIATRY South West Peninsula MRCPsych Course
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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
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Brief Information on Paper 1 of the MRCPsych
Basic psychological processes
Human psychological development
Social psychology Description and
measurement Basic psychological
treatments Prevention of psychiatric
disorder Descriptive
psychopathology Dynamic psychopathology **History of
psychiatry** Basic ethics and philosophy
of psychiatry Stigma and culture
General AdultHistory and mental state examinationCognitive assessmentNeurological examinationAssessmentAetiologyDiagnosisClassificationBasic Psychopharmacology
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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.
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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)
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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
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HISTORY OF PSYCHIATRY South West Peninsula MRCPsych Course
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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
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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
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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
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Asylum the Good Bad and Ugly
POSITIVE NEGATIVEPublic 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
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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)
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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)
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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
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Lunacy Acts 1890 Clunis
Report
Years
1WW
2WW
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Psychiatry History in the Cinema
Witch finder General (1968 Michael 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)
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Core Training
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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
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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
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Portfolio Details of individual posts held including job plan, timetable,
learning objectives, and progress towards achieving objectives
Log or record of clinical activity (type and number of clinical contacts)
Record of psychotherapy experience and supervision All workplace based assessments including observed clinical
practice and any other clinical review data List of competencies relevant to ST level Audit reports/records Reflective notes (e.g. consideration of significant events) Record of teaching activity including feedback or other
assessment data Records of clinical and educational supervision Declaration of interests
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Portfolio (continuation)
Note of any health concerns Management activity (e.g. committee or project work) Research activity including supervision record, ethical
committee application/approval, presentations, publications Record of posters and presentations (e.g. at College Divisional
or Faculty meetings) Examinations taken and results Copies of important documents such as GMC registration,
membership certificates Copies of NHS appraisal sign off Structured reports from supervisors and tutors