• Mild Depression → initial approach is a 2 week watch and wait period. If symptoms still present after this, offer low-intensity psychological interventions (CBT).
• At-Risk Mental State → prodromal phase of social withdrawal in schizophrenia. Negative symptoms dominant, loss of interest in work and relationships, typically from teens to early 20s.
• Delirium → memory services will not assess a patient if they have had an episode of delirium within the last 6 weeks due to residual effects altering result of assessment.
• Dysarthria → difficulty getting words out (but can understand and answer questions appropriately).
• Baby Blues → should resolve by days 10-14. If past this point, more likely to be postpartum depression.
• Quetiapine → atypical antipsychotic least associated with weight gain.
• Section 4 → admission for emergency treatment for 72 hrs. Used when section 2/3 would cause undue delay (can be done in A&E). May then be converted into section 2.
• Normal Pressure Hydrocephalus → reversible cause of dementia in elderly patients. Urinary incontinence + dementia + gait abnormality. Management is ventriculoperitoneal shunt.
• Zopiclone → avoid in elderly as it causes ataxia and postural hypotension, which increases risk of falls.
• Sertraline → max daily dose is 200mg.
• Insomnia → if daytime impairment, alongside sleep advice prescribe a 2-week course of a short-acting benzodiazepine such as temazepam (or z-drugs like zopiclone). For people >55 with persistent insomnia, consider treatment with a modified-release melatonin.
• Delirium → PO antipsychotics (haloperidol) is NICE recommended. Avoid anticholinergics.
• Rapid Tranquillisation → use either IM lorazepam or combination of IM haloperidol + IM promethazine. Always offer oral medication first (allow for at least 1 hour to assess response).
• Somatic Passivity → sensations being imposed on them (first-rank symptom). [Passivity: someone else trying to control you].
• Self-Harm → ensure follow-up has been offered in primary care to all people who have self-harmed within 48 hours.
• Overdose → arrange a psychiatric team review prior to discharge.
• Delusions of Reference → belief that ordinary events has a meaning specifically for the person.
• First-Episode Psychosis → refer to early intervention in psychosis team. If urgent, refer to crisis resolution and home treatment team. In primary care, do not start antipsychotic medication for a first presentation of sustained psychotic symptoms unless done in consultation with a consultant psychiatrist.
• Schizoaffective → need a period of 2 weeks where psychotic symptoms are present in absence of mood symptoms. If psychotic symptoms only come on at time of mood symptoms, more likely to be major depressive disorder with psychotic features or mania with psychosis.
• Self-Harm in Children → admit and urgent CAMHS assessment prior to discharge in all children who self-harm / attempt suicide.
  • Any Patient following Self-Harm / Suicide → arrange review by mental health liaison team prior to discharge.