Psychiatry Clerkship Guide
Psychiatry is a branch of medicine that focuses on the diagnosis, treatment, and prevention of mental, emotional, and behavioral disorders. It plays a vital role in addressing the holistic well-being of individuals and communities.
As a PA student, your role in psychiatry is crucial, as you will be working alongside healthcare professionals to provide comprehensive care to patients with mental health conditions.
I. Overview of Psychiatry
a) What is Psychiatry?
Psychiatry is the medical specialty dedicated to the diagnosis, treatment, and prevention of mental illnesses. Mental health is just as crucial as physical health, and psychiatry plays a vital role in addressing the holistic well-being of individuals. It involves understanding the complex interplay of biological, psychological, and social factors that contribute to mental health disorders.
b) Subspecialties in Psychiatry
Psychiatry encompasses various subspecialties, each focusing on specific areas of mental health. Familiarizing yourself with these subspecialties will broaden your understanding of the diverse spectrum of psychiatric care.
Some common subspecialties include:
Child and Adolescent Psychiatry: Focuses on the mental health of children and adolescents, addressing developmental disorders, behavioral issues, and emotional challenges specific to these age groups.
Geriatric Psychiatry: Specializes in the mental health needs of older adults, including age-related cognitive decline, mood disorders, and addressing the unique challenges faced by this population.
Addiction Psychiatry: Deals with substance use disorders and co-occurring mental health conditions, providing comprehensive care and support to individuals struggling with addiction.
Forensic Psychiatry: Involves the intersection of mental health and the legal system, evaluating and treating individuals within legal contexts, such as competency evaluations and insanity defenses.
Consultation-Liaison Psychiatry: Provides psychiatric consultation and care to individuals admitted to general medical or surgical units, addressing the psychiatric aspects of their physical health conditions.
Psychosomatic Medicine: Focuses on the connection between mental and physical health, understanding how psychological factors can influence physical well-being and vice versa.
Emergency Psychiatry: Deals with acute psychiatric emergencies, providing immediate assessment and intervention to individuals in crisis.
II. Preparing for Psychiatry Clerkship
a) Get Familiar with the DSM
The Diagnostic and Statistical Manual of Mental Disorder (DSM) is a critical tool used in psychiatry for diagnosing mental disorders. It provides a standardized system of classification, diagnostic criteria, and descriptive information for mental health conditions.
Becoming familiar with the DSM is essential for accurate assessment and treatment planning.
Here are some tips to navigate and utilize the DSM effectively:
Study the organization and structure: Understand how the DSM is organized, including the different sections and diagnostic criteria for each disorder category.
Focus on common disorders: Prioritize learning about frequently encountered psychiatric disorders, such as major depressive disorder, anxiety disorders, bipolar disorder, schizophrenia, and substance use disorders.
Pay attention to diagnostic criteria: Familiarize yourself with the specific diagnostic criteria for each disorder, including the necessary duration and severity of symptoms.
Utilize case-based learning: Work through case studies that illustrate the application of the DSM criteria in real-world scenarios. This will help you apply your knowledge to clinical practice.
b) Review Essential Psychiatric Conditions and Symptoms
Within the DSM-5, there are 22 significant categories encompassing over 150 distinct mental disorders. These classification systems serve various purposes, including distinguishing between different psychiatric diagnoses to enable clinicians to provide optimal treatment. Additionally, they establish a shared language among healthcare professionals
Psychiatric Classificaiton and Common Psychiatric Disorders: Study the epidemiology, etiology, clinical presentation, and treatment approaches for disorders such as major depressive disorder, generalized anxiety disorder, schizophrenia, bipolar disorder, post-traumatic stress disorder (PTSD), and attention-deficit/hyperactivity disorder (ADHD).
Neurodevelopmental Disorders:
Autism Spectrum Disorder
Attention-Deficit/Hyperactivity Disorder (ADHD)
Intellectual Disability
Specific Learning Disorder
Communication Disorders
Schizophrenia Spectrum and Other Psychotic Disorders:
Schizophrenia
Schizoaffective Disorder
Delusional Disorder
Brief Psychotic Disorder
Schizophreniform Disorder
Bipolar and Related Disorders:
Bipolar I Disorder
Bipolar II Disorder
Cyclothymic Disorder
Substance/Medication-Induced Bipolar and Related Disorder
Depressive Disorders:
Major Depressive Disorder
Persistent Depressive Disorder (Dysthymia)
Premenstrual Dysphoric Disorder
Substance/Medication-Induced Depressive Disorder
Anxiety Disorders:
Generalized Anxiety Disorder
Panic Disorder
Social Anxiety Disorder (Social Phobia)
Specific Phobia
Separation Anxiety Disorder
Obsessive-Compulsive and Related Disorders:
Obsessive-Compulsive Disorder (OCD)
Body Dysmorphic Disorder
Hoarding Disorder
Trichotillomania (Hair-Pulling Disorder)
Excoriation (Skin-Picking) Disorder
Trauma- and Stressor-Related Disorders:
Posttraumatic Stress Disorder (PTSD)
Acute Stress Disorder
Adjustment Disorders
Reactive Attachment Disorder
Dissociative Disorders:
Dissociative Identity Disorder
Dissociative Amnesia
Depersonalization/Derealization Disorder
Somatic Symptom and Related Disorders:
Somatic Symptom Disorder
Illness Anxiety Disorder
Conversion Disorder (Functional Neurological Symptom Disorder)
Feeding and Eating Disorders:
Anorexia Nervosa
Bulimia Nervosa
Binge-Eating Disorder
Avoidant/Restrictive Food Intake Disorder
Elimination Disorders:
Enuresis (Bed-wetting)
Encopresis (Fecal Incontinence)
Sleep-Wake Disorders:
Insomnia Disorder
Sleep Apnea
Narcolepsy
Restless Legs Syndrome
Circadian Rhythm Sleep-Wake Disorders
Sexual Dysfunctions:
Erectile Disorder
Female Orgasmic Disorder
Premature (Early) Ejaculation
Female Sexual Interest/Arousal Disorder
Genito-Pelvic Pain/Penetration Disorder
Gender Dysphoria:
Gender Dysphoria in Adolescents and Adults
Gender Dysphoria in Children
Disruptive, Impulse-Control, and Conduct Disorders:
Oppositional Defiant Disorder
Conduct Disorder
Intermittent Explosive Disorder
Pyromania
Kleptomania
Substance-Related and Addictive Disorders:
Substance Use Disorder
Alcohol Use Disorder
Opioid Use Disorder
Stimulant Use Disorder
Cannabis Use Disorder
Neurocognitive Disorders:
Major Neurocognitive Disorder (Dementia)
Mild Neurocognitive Disorder
Delirium
Personality Disorders:
Borderline Personality Disorder
Antisocial Personality Disorder
Avoidant Personality Disorder
Narcissistic Personality Disorder
Obsessive-Compulsive Personality Disorder
Paraphilic Disorders:
Voyeuristic Disorder
Exhibitionistic Disorder
Frotteuristic Disorder
Pedophilic Disorder
Sexual Masochism and Sadism Disorders
Other Mental Disorders:
Other specified mental disorders (e.g., Other Specified Schizophrenia Spectrum and Other Psychotic Disorder)
Medication-Induced Movement Disorders and Other Adverse Effects of Medication:
Tardive Dyskinesia
Neuroleptic Malignant Syndrome
Medication-Induced Parkinsonism
Antipsychotic-Induced Acute Akathisia
Medication-Induced Acute Dystonia
Other Conditions That May Be a Focus of Clinical Attention:
Other specified conditions that may be a focus of clinical attention
Unspecified conditions that may be a focus of clinical attention
Key Symptoms and Diagnostic Criteria: Learn the hallmark symptoms and diagnostic criteria for each disorder, as outlined in the DSM. Understanding these criteria will aid in accurate diagnosis and formulation of treatment plans.
Case-Based Learning: Engage in case discussions and role-play scenarios to apply your knowledge to realistic patient encounters. This will enhance your clinical reasoning skills and prepare you for real-world challenges.
c) Build Foundations in Common Medications used in Psychiatry
Overview of Psychotropic Medications: Understand the different classes of psychiatric medications, their mechanisms of action and therapeutic indications.
Antidepressants: These medications are primarily used to treat depression, but they can also be effective for anxiety disorders and certain other conditions. Examples include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs).
Antipsychotics: Also known as neuroleptics, antipsychotics are used to manage psychotic symptoms, such as hallucinations and delusions, associated with conditions like schizophrenia and bipolar disorder. They can be categorized as typical (first-generation) antipsychotics or atypical (second-generation) antipsychotics.
Anxiolytics (Anti-Anxiety Medications): These medications are prescribed to alleviate symptoms of anxiety disorders, such as generalized anxiety disorder, panic disorder, and social anxiety disorder. Commonly prescribed anxiolytics include benzodiazepines (e.g., lorazepam, diazepam) and certain antidepressants (e.g., SSRIs, SNRIs).
Mood Stabilizers: Mood stabilizers are primarily used to manage bipolar disorder and help stabilize mood fluctuations. Lithium is a well-known mood stabilizer, and other options include anticonvulsant medications such as valproate and lamotrigine.
Stimulants: Stimulant medications are primarily used to treat attention-deficit/hyperactivity disorder (ADHD) by improving attention, focus, and impulse control. Examples include methylphenidate (Ritalin) and amphetamine-based medications (Adderall).
Sedative-Hypnotics: These medications are prescribed to promote sleep and manage sleep disorders, such as insomnia. Benzodiazepines and non-benzodiazepine sedative-hypnotics, such as zolpidem (Ambien) and eszopiclone (Lunesta), fall into this category.
Anticonvulsants: While primarily used to treat epilepsy, anticonvulsant medications can also be prescribed for mood stabilization in conditions like bipolar disorder. Examples include valproate, carbamazepine, and lamotrigine.
Psychostimulants: These medications are prescribed for conditions such as ADHD and narcolepsy. They work by increasing alertness and improving focus. Commonly used psychostimulants include methylphenidate and amphetamines.
The 6D’s of Psychotropic Drug Therapy: Optimizing the results of psychotropic drug therapy involves consideration of the six Ds: diagnosis, drug selection, dosage, duration, discontinuation, and dialogue.
Diagnosis: Accurate diagnosis is crucial in psychotropic drug therapy. A thorough evaluation and assessment of the patient's symptoms, history, and overall mental health are essential for determining the most appropriate treatment approach.
Drug Selection: Choosing the right psychotropic medication is based on several factors, including the diagnosed mental health condition, the patient's specific symptoms and their severity, the potential side effects, and individual patient characteristics such as age, medical history, and concurrent medications. The goal is to find the medication that best matches the patient's needs and is most likely to be effective.
Dosage: Determining the appropriate dosage of the chosen medication is essential. Factors such as the patient's age, weight, liver and kidney function, and response to the medication must be taken into account. Starting with a lower dose and gradually titrating up to the effective therapeutic dose helps minimize side effects and maximize treatment benefits.
Duration: The duration of psychotropic drug therapy depends on the specific mental health condition being treated. Some conditions may require short-term treatment, while others may necessitate long-term or even lifelong medication use. Regular monitoring and evaluation are essential to assess the ongoing need for medication and make adjustments as necessary.
Discontinuation: In some cases, discontinuation of psychotropic medications may be appropriate. However, it should be done gradually and under the supervision of a healthcare professional to prevent withdrawal symptoms and recurrence of symptoms. Discontinuation should be carefully considered, taking into account the patient's progress, treatment response, and potential risks and benefits.
Dialogue: Maintaining open and ongoing dialogue between the healthcare provider and the patient is crucial throughout the course of psychotropic drug therapy. Regular check-ins, follow-up appointments, and discussions about treatment goals, progress, side effects, and any concerns or questions the patient may have contribute to optimizing treatment outcomes and ensuring patient satisfaction.
There are special considerations for chidren, the elderly, pregnant and nursing women, and medically ill persons (e.g. smaller doses, avoidance of psychotropic medications, conservative management).
d) Different Types of Psychotherapy
Psychotherapy, also known as talk therapy or counseling, is a collaborative process between a trained mental health professional and an individual or group seeking support for emotional, psychological, or behavioral challenges.
It involves various therapeutic techniques and approaches aimed at helping individuals gain insight, develop coping strategies, and make positive changes in their thoughts, feelings, and behaviors.
As PA students, and future health care providers, udnerstanding the different types of psychotherapy modalities available allows you to consider psychotherapeutic interventions as part of a holistic treatment approac, make appropriate referrals.
Psychoanalysis: A therapeutic approach that focuses on exploring unconscious thoughts, emotions, and past experiences to gain insight into current difficulties and promote personal growth.
Behavioural Therapy: A type of therapy that focuses on modifying behavior patterns through techniques such as reinforcement, conditioning, and exposure to help individuals develop healthier and more adaptive behaviors.
Cognitive-Behavioural Therapy (CBT): A time-limited, goal-oriented therapy that examines the relationship between thoughts, feelings, and behaviors, aiming to identify and change negative thought patterns and behaviors that contribute to distress.
Family Therapy: A therapeutic approach that involves working with the entire family system to improve communication, resolve conflicts, and promote understanding and support among family members.
Interpersonal Therapy: A short-term therapy that focuses on improving interpersonal relationships and addressing specific issues by exploring patterns of communication, attachment, and social roles.
Group Therapy: A form of therapy that involves a small group of individuals with similar concerns or goals who meet regularly, providing support, feedback, and a safe space to explore personal experiences and interpersonal dynamics.
Couple and Marital Therapy: A specialized therapy that focuses on improving communication, resolving conflicts, and strengthening the relationship between partners, with the goal of enhancing intimacy and overall relationship satisfaction.
Dialectical Behavioural Therapy (DBT): A comprehensive therapy that combines cognitive-behavioral techniques with mindfulness practices to help individuals develop emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness skills.
Paradoxical Therapy: A therapeutic approach that challenges clients' expectations by prescribing or encouraging the symptoms or behaviors they seek to change, with the intention of promoting self-reflection and shifting perspectives.
Sex Therapy: A specialized therapy that addresses sexual concerns, dysfunctions, and conflicts, helping individuals or couples explore and improve their sexual health and well-being.
Narrative Psychotherapy: A therapeutic approach that focuses on the stories and narratives individuals construct about their lives, helping them gain insight, reframe experiences, and create new narratives that promote growth and resilience.
Vocational Rehabilitation: A type of therapy that focuses on helping individuals with mental health conditions develop skills, access resources, and overcome barriers to return to or maintain meaningful employment.
Combined Therapy: An integrative approach that combines different therapeutic modalities or techniques tailored to the individual's specific needs, drawing from multiple theories and approaches to address complex challenges.
III. Mastering Clinical Skills in Psychiatry
a) Conducting a Psychiatric Interview
The psychiatric interview is a fundamental component of the diagnostic process in psychiatry. It allows you to gather essential information about the patient's history, symptoms, and psychosocial context. Here are key components to focus on:
Introduction and Rapport Building: Greet the patient and establish a welcoming and non-judgmental atmosphere. Introduce yourself and explain the purpose of the interview. Establish rapport by actively listening and showing empathy.
Establishing Rapport: Build a therapeutic relationship with your patients by displaying empathy, active listening, and non-judgmental attitudes. Create a safe and trusting environment where patients feel comfortable sharing their experiences.
Structuring the Interview: Use a systematic approach to gather relevant information. Begin with an open-ended exploration of the patient's concerns, followed by targeted questions to assess specific symptoms, such as mood, sleep, appetite, and cognition.
Assessing Suicide Risk and Safety: Be thorough in evaluating suicide risk, ensuring patient safety is prioritized. Learn to ask direct questions about suicidal thoughts, intent, and previous attempts. Develop strategies for appropriate intervention and referral as needed.
Psychiatric History Taking Sample Outline
Patient ID: Gather basic demographic details (name, age, gender, etc.).
Chief Complaint: Explore the reason for the visit and the patient's chief complaint. Clarify any concerns or expectations the patient may have.
History of Presenting Illness: Explore the current symptoms in detail. Determine the onset, duration, and progression of symptoms. Identify any triggers or factors that worsen or alleviate the symptoms. Assess the impact of symptoms on daily functioning and quality of life.
Past Psychiatric History
Previous Mental Health Treatment: Inquire about any previous mental health diagnoses, treatments, and hospitalizations. Ask about the effectiveness and side effects of past treatments.
Psychiatric Medications: Obtain a detailed history of current and past psychiatric medications. Explore adherence, response to medications, and any adverse effects experienced.
Substance Use History: Assess the patient's history of substance use, including alcohol, tobacco, and illicit drugs. Determine frequency, quantity, duration, and any related difficulties or consequences.
Past Psychiatric History: Inquire about any previous episodes of mental health symptoms or disorders. Explore the course, treatment, and outcomes of past episodes.
Family Psychiatric History: Collect information about mental health issues in the patient's immediate family. Identify any patterns or familial predispositions to specific disorders.
Personal and Social History:
Personal History: Only collect information where relevant
Early childhood 0-3 years of age (feeding habits, early developmenting, behavioural problems, personal and temperment)
Middle Childhood (3 to 11 years) - early school history, early adjustment, gender identification, social relationships, attitudes towards peers and siblings
Later Childhood (prepuberty through adolescence): peer relationships, school history, cognitive and motor development, emotional or physical problems e.g. smoking, drug use, phobias, etc., psychosexual history, regligious background
Adulthood: occupational history, any military history, relationships and marital history, sexual practices
Education and Employment: Explore the patient's educational background and current employment status. Assess any challenges or stressors related to work or school.
Relationships and Support System: Inquire about the patient's current relationships and support networks. Identify sources of support and potential sources of conflict or stress.
Trauma History: Sensitively ask about any history of traumatic experiences. Assess the impact of trauma on the patient's mental health and functioning.
Cultural and Spiritual Considerations: Respectfully explore the patient's cultural and spiritual beliefs. Discuss the role of culture and spirituality in the patient's life and coping strategies.
Past Medical History: Medical Conditions, Past Surgeries, Past Hospitalizations, List of Medications, and Allergies.
Review of Systems: Conduct a brief assessment of physical symptoms across body systems. Inquire about sleep patterns, appetite changes, energy levels, and any other relevant symptoms.
b) Performing the Mini-Mental Status Exam (MMSE)
A patient's history tends to stay the same, while their mental status can vary throughout the day or even hour to hour. When conducting an evaluation, the mini mental status examination (MMSE) assesses several cognitive domains, including orientation, registration, attention and calculation, recall, language and naming, repetition, reading and comprehension, writing, and visuospatial skills. It provides a brief snapshot of cognitive function and can help identify potential cognitive impairments or changes over time.
MMSE
I. Orientation
Ask the patient for their current location (e.g., country, state, city).
Inquire about the current date (day, month, year).
Determine the patient's knowledge of their own current location and the date.
II. Registration
Ask the patient to repeat and remember three unrelated words.
Repeat the three words and ask the patient to recall them after a brief distraction.
III. Attention and Calculation
Ask the patient to perform simple calculations, such as serial sevens or spelling a word backward.
Evaluate the patient's ability to sustain attention and mental calculations.
IV. Recall
Prompt the patient to recall the three words provided during the registration phase.
V. Language and Naming'
Ask the patient to name common objects, such as a pen or a watch.
Assess the patient's ability to follow simple verbal instructions.
VI. Repetition
Ask the patient to repeat a phrase or sentence after you.
VII. Reading and Comprehension
Ask the patient to read a written sentence or a short paragraph aloud.
Assess the patient's understanding of the written material.
VIII. Writing
Ask the patient to write a sentence or a specific word.
Evaluate the patient's ability to produce written language.
IX. Interpreting a Visual Task
Show the patient a simple drawing or diagram and ask them to interpret or copy it.
X. Closure
Thank the patient for their participation and summarize the tasks performed.
Provide any necessary follow-up instructions or referrals based on the findings.
c) Documentation in Psychiatry
Objective and Subjective Information: Include both objective findings from the MSE, laboratory results, and subjective information obtained from the patient and collateral sources.
Focused and Relevant Details: Document pertinent details related to the patient's psychiatric symptoms, history, and response to treatment. Be concise yet comprehensive, ensuring information is organized and easily accessible.
Maintaining Patient Confidentiality: Adhere to patient privacy and confidentiality guidelines, ensuring sensitive information is protected. Avoid including unnecessary personal identifiers in the documentation.
Professional Language and Terminology: Utilize clear and professional language when describing symptoms, observations, and treatment plans. Use standardized psychiatric terminology to enhance clarity and precision.
IV. Helpful Mnemonics in Psychiatry
Some acronyms serve as helpful screening tools in clinical practice, aiding in the identification of potential mental health concerns or specific symptoms. They provide a structured and standardized approach to assessment and can assist in initiating further evaluation, diagnosis, and appropriate interventions.
CAGE Questionnaire (Alcoholism):
C: Have you ever felt the need to cut down on your drinking?
A: Have people annoyed you by criticizing your drinking?
G: Have you ever felt guilty about your drinking?
E: Eye-opener - Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?
PHQ-9 (Depression):
P: Have you experienced persistent feelings of sadness or depression?
H: Have you lost interest or pleasure in most activities?
Q-9: Nine questions assessing various symptoms of depression, such as changes in sleep, appetite, energy, concentration, feelings of worthlessness, and thoughts of self-harm.
GAD-7 (Generalized Anxiety Disorder):
G: Have you experienced excessive worrying or felt on edge?
A: Have you had difficulty controlling your worry?
D-7: Seven questions assessing various symptoms of generalized anxiety disorder, including restlessness, irritability, muscle tension, sleep disturbances, and difficulties concentrating.
SCOFF Questionnaire (Eating Disorders):
S: Do you make yourself Sick because you feel uncomfortably full?
C: Do you worry about losing Control over your eating?
O: Have you recently lost a significant amount of weight?
F: Do you believe you are Fat even though others say you are thin?
F: Would you say that Food dominates your life?
IS PATH WARM (Suicide Risk Assessment):
I - Ideation: Assess for the presence of suicidal thoughts or ideation.
S - Substance Abuse: Evaluate for any substance abuse or increased use as it may elevate suicide risk.
P - Purposelessness: Explore whether the person expresses feelings of hopelessness or a lack of purpose in life.
A - Anxiety: Assess for the presence of anxiety, agitation, or restlessness, as these can contribute to increased suicide risk.
T - Trapped: Determine if the person feels trapped or believes there is no way out of their current situation.
H - Hopelessness: Evaluate for feelings of hopelessness, helplessness, or a lack of optimism for the future.
W - Withdrawal: Assess for social withdrawal or isolation, as well as a loss of interest in previously enjoyed activities.
A - Anger: Evaluate for increased anger, irritability, or aggressiveness, as these emotions can be indicators of heightened suicide risk.
R - Recklessness: Explore whether the person engages in risky or impulsive behaviors that may indicate a disregard for personal safety.
M - Mood Changes: Assess for significant changes in mood, particularly if there is a sudden improvement after a period of depression, as it may indicate a decision to attempt suicide.
V. Recommended Books & Resources for Psychiatry Clerkship
a) Psychiatry Pocket Books
"First Aid for the Psychiatry Clerkship" by Latha Ganti and Matthew S. Kaufman: This popular handbook follows the well-known First Aid format, presenting essential information, clinical pearls, and high-yield facts. It covers the major topics encountered during a Psychiatry clerkship and includes case studies and exam-style questions.
"Case Files Psychiatry" by Eugene Toy, Debra Klamen, and Elizabeth J. Almekinder: This handbook presents real-life patient cases, helping you develop clinical reasoning skills and apply your knowledge to clinical scenarios. It includes case discussions, key concepts, and useful mnemonics.
"Oxford Handbook of Psychiatry" by David Semple and Roger Smyth: This comprehensive handbook covers a wide range of psychiatric disorders, treatment approaches, and important clinical considerations. It offers evidence-based information, practical guidance, and quick reference tables.
"The Massachusetts General Hospital/McLean Residency Handbook of Psychiatry” is a comprehensive and concise resource that covers a wide range of psychiatric disorders, treatment modalities, and clinical concepts. It provides practical guidance and evidence-based information for psychiatry residents and clinicians, supporting them in their clinical practice and enhancing patient care.
b) Psychiatry Online Resources
Medscape Psychiatry (www.medscape.com/psychiatry): Medscape offers a comprehensive collection of psychiatry articles, clinical guidelines, case studies, and educational materials. It provides up-to-date information on psychiatric conditions, treatment options, and emerging research in the field.
American Psychiatric Association (APA) (www.psychiatry.org): The APA website offers a wealth of resources, including practice guidelines, educational materials, and publications. It also provides access to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and relevant updates, which are essential references in psychiatric practice.
Psychiatry Online (psychiatryonline.org): Psychiatry Online is an online platform that provides access to psychiatric textbooks, journals, and practice guidelines. It offers a range of resources for studying different psychiatric conditions, treatment modalities, and psychopharmacology.
National Institute of Mental Health (NIMH) (www.nimh.nih.gov): NIMH provides valuable information on various mental health conditions, research findings, and treatment approaches. Their website offers educational resources, research updates, and information on clinical trials, allowing you to stay informed about the latest advancements in the field.
UpToDate (www.uptodate.com): UpToDate is a widely used clinical decision support resource that covers various medical specialties, including psychiatry. It provides evidence-based content on psychiatric disorders, diagnostics, treatment options, and management strategies. It is particularly useful for quick reference and staying up-to-date with current guidelines and recommendations.
c) Psychiatry Textbooks
In general, you do not have to obtain textbooks to get through your rotation.
However if you do have access to these books through your university or hospital library (electronic or physical copies), try to find these texts:
"Kaplan and Sadock's Comprehensive Textbook of Psychiatry" by Benjamin J. Sadock, Virginia A. Sadock, and Pedro Ruiz: This comprehensive textbook provides an in-depth exploration of the field of psychiatry, covering a wide range of psychiatric disorders, treatment approaches, and relevant clinical considerations. It offers detailed information on psychiatric assessment, diagnostic criteria, psychopharmacology, psychotherapy, and various subspecialties within psychiatry.
”DSM-5 Diagnostic and Statistical Manual of Mental Disorders” by APA; is a widely used diagnostic manual that provides criteria for the classification and diagnosis of mental disorders. This special edition offers an updated and comprehensive resource for clinicians, researchers, and students to accurately identify and classify mental health conditions based on standardized criteria.
"The DSM-5 Handbook of Differential Diagnosis" by Michael B. First: This handbook is a valuable resource for understanding and applying the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in clinical practice. It provides guidance on making accurate differential diagnoses by presenting a structured approach to evaluating symptoms, ruling out alternative explanations, and identifying the most appropriate diagnostic category based on the DSM-5 criteria.
Final notes
Completing a clinical clerkship in Psychiatry provides you with an invaluable opportunity to gain firsthand experience in the field of mental health. This clerkship guide has equipped you with a comprehensive overview of essential aspects to consider during this rotation.
From recognizing the importance of building rapport with patients to familiarizing yourself with various psychiatric diagnoses and treatment modalities, you can enhance your knowledge and skills in providing comprehensive care for individuals with mental health conditions.
