6 episodes

Psychiatric interviews created for teaching purposes.

Psychiatric videos for teaching University of Nottingham

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Psychiatric interviews created for teaching purposes.

    • video
    Psychiatric Interviews for Teaching: Somatisation

    Psychiatric Interviews for Teaching: Somatisation

    In this film, you see a GP talking to a patient who has repeatedly presented to the surgery for abdominal problems for which no organic cause has been found. The GP asks the patients at length about her symptoms. The information is already in the GP notes, but the GP knows that if the patient is to trust the advice given, she must first feel that the history has been heard and understood by the new doctor.

    It is apparent that the symptoms are more problematic when the patient is lonely, and also apparent that her social life has greatly reduced since the problems began. The patient thinks that she has a medical problem which doctors have not yet diagnosed, and she requests more tests. Despite pressure, the GP holds firm that further tests are not needed. The GP avoids getting into an argument about whether the problems are physical or psychological by suggesting that both these factors may be contributing.

    The GP then suggests that as the attempts at treatment so far have not worked, they might want to try a different approach for a few months, as a trial. The patient remains cynical, but does at least agree to come and see the GP again.

    In conditions such as somatisation, it can be helpful for the patient to see the same doctor so that unnecessary tests can be avoided.

    • 17 min
    • video
    Psychiatric Interviews for Teaching: Anxiety

    Psychiatric Interviews for Teaching: Anxiety

    In this film, the GP is seeing a patient who has presented several times before with complaints of palpitations and shortness of breath.

    The patient describes the onset of her problems, which was a panic attack. She has then gone on to develop agoraphobia. The problem has affected a number of areas of her life.

    The GP explores the patient's understanding of the problem and it is apparent that she has attributed this to a problem with her heart. The GP then goes on to give the patient an alternative explanation; that this is anxiety. She describes the physiological symptoms of anxiety and explains why avoidance is a problem.

    • 12 min
    • video
    Psychiatric Interviews for Teaching: Depression

    Psychiatric Interviews for Teaching: Depression

    In this film, the GP is seeing a patient who has a depressive disorder. The patient describes symptoms including low mood, tearfulness, reduced energy, reduced motivation, early morning wakening, loss of appetite, weight loss, poor concentration, reduced enjoyment and reduced interest in self-care.

    The GP explores the effect of the symptoms on other people in the patient's life, explores the past history of low mood, and makes an assessment of suicide risk. The GP then gives the patient an explanation of depression.

    • 14 min
    • video
    Psychiatric Interviews for Teaching: Psychosis

    Psychiatric Interviews for Teaching: Psychosis

    In this film, an on-call psychiatrist is assessing a young man who has been referred urgently by his GP. The psychiatrist takes a history in which she elicits persecutory delusions, third person auditory hallucinations, running commentary, thought insertion, and somatic hallucinations. She then makes a risk assessment, takes a drug history and assesses risk.

    The patient is clearly suffering from a psychotic disorder and the most likely diagnosis is schizophrenia. Differential diagnoses would include a drug-induced psychosis.

    • 12 min
    • video
    Psychiatric Interviews for Teaching: Self-Harm

    Psychiatric Interviews for Teaching: Self-Harm

    In this film, you see a psychiatrist who works in the liaison psychiatry department seeing a patient who has recently been treated in the emergency department for wrist lacerations. The lacerations were self-inflicted after a relationship ended.

    The patient describes an emotional response to the end of a relatively short-lived relationship. She also gives a history of cutting since her teenage years and she is aware that she uses cutting to manage difficult emotions. She describes very low self-esteem and also some past alcohol misuse and binge/purge behaviours. She gives an account of hearing voices that are inside her head. There appears to be a pattern in her relationships of rapid attachment and then a strong sense of abandonment when they end. Towards the end of the interview, the patient appears to re-play this pattern in her relationship with the psychiatrist. However, the psychiatrist maintains a firm boundary.

    This patient displays features of Emotionally Unstable Personality Disorder of the Borderline type. We may speculate that the origins of her problems lie in her childhood experiences.

    • 11 min
    • video
    Psychiatric Interviews for Teaching: Mania

    Psychiatric Interviews for Teaching: Mania

    In this film, a psychiatrist assesses a man who has been referred by his GP. The patient demonstrates flight of ideas, pressure of speech, disinhibition, punning, grandiose delusions, and second person auditory hallucinations. His presentation is consistent with mania.

    • 9 min

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