Presentations
- Cognitive impairment
- High prevalence disorders, such as:
- adjustment disorders
- anxiety disorders
- depression
- Lower prevalence and high acuity mental disorders, such as:
- bipolar disorder
- eating disorders
- other severe mood disorders
- psychotic disorders
- severe anxiety
- severe personality disorders
- Psychological distress without mental disorder
Conditions
- Alcohol spectrum disorder
- Anxiety and mood disorders, and trauma-related disorders
- Eating disorders
- Fetal alcohol spectrum disorder (FASD)
- Learning disorders
- Personality disorders
- Psychotic disorders
- Substance-induced and other types of neurocognitive disorder
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients' needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Presentations
- Ongoing severely challenging behaviours with forensic implications
- Severe borderline personality disorders
Conditions
- Impaired legal capacity due to an enduring condition affecting cognitive impairment
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients' needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Common comorbidity patterns
- Developmental and personality-related predictors of mental disorders, including:
- family history
- impulsivity
- personality disorders
- trauma
- Neurobiological understandings of mental disorders and brain injury
- Underlying evidence behind interventions
Clinical tools
- Cognitive assessment tools relevant to assessing delirium and cognitive impairment
- Mental health measures, such as Kessler Psychological Distress Scale (K10)
- Outcome measures
Examinations
- Mental state examination, including cognitive assessment where screen is positive
- Common determinants of the presentations and conditions, such as:
- developmental
- early childhood
- genetic
- Community-based supports, such as NDIS
- Comprehensive assessment (history and examination), including:
- assessing risk of harm to others
- cognitive screening
- history of mental health disorders or brain injury
- mental state examination
- suicide risk assessment
- Consider using legal measures to assist cognitively impaired patients with self-management
- Dual diagnosis quadrant model used as a guide to what can be managed in primary care or alcohol and other drug (AOD) services, mental health support (MHS) services, or shared care between AOD and MHS services
- FASD in Aboriginal and Torres Strait Islander and other peoples, and the related public health and clinical aspects
- Harms and stigmas associated with presentations and conditions
- Importance of considering comorbidities in management in jurisdictions where mandated treatment measures exist, considering their suitability for the patient, with the intention of improving the patient’s outcomes
- In the absence of underlying mental health disorders, the relationship between substance use, addictive behaviours, and psychological distress
- Involve multidisciplinary teams as severity and complexity increase
- Involve primary care / general practice and specialist mental health services as partners in shared care
- Patients’ readiness for change in the development of action / management plans
- Services and supports that are appropriate for Aboriginal and Torres Strait Islander people and Māori
- The inter-relationships between substance use and addictive behaviours and these conditions
- The role of dialectical behaviour therapy (DBT) in people with borderline personality disorder ready for change
- The role of multidisciplinary care for people with substance use and addictive disorders, and concurrent mental health problems and/or cognitive impairment
- The role of patients’ family or friends as therapeutic supports
- The role of self-help and peer support programs for patients and/or their families
- The use of management plans developed in collaboration with patients and other health professionals which are based on motivational enhancement and cognitive behavioural interventions, together with substance use and addictive behaviours
