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Personality disorder

Discussion in 'PSYCHIATRY SPECIALITIES' started by Johnson, Sep 21, 2016.

  1. Johnson

    Johnson Subscribed

    Chris Brennan inquest: Hospital neglect 'contributed to teenager's death'
    http://www.bbc.co.uk/news/uk-england-london-37430212

    Any discussion in this thread is strictly for psychiatrists and medical professionals only

    There are very important lessons to learn from this inquest.

    First of all its a sad news

    There is always lessons to be leanrt
    1. up to date risk assessments and care plans
    2. About desensitization
     
    Last edited: Sep 22, 2016
  2. Johnson

    Johnson Subscribed

    with my limited experiences in general adult- 50 days as locum Specilaity doctor, I am learning that some EUPD could be treated
    [ the reason to share is not to take my experiences with me to the grave yard]

    Its too early for any conclusions, but of course with my bizarre inferences I am able to see a pattern

    There is no single treatment that could apply for everyone

    Initially its all over the place - with medication, sometimes things could be unpicked

    Now I feels there is mood element

    Before I believed in death by misadventure, now to a lesser extent

    Some of my inferences
    - Treatment should be as early as possible

    - Medications to consider - mirtazapine, lamotrigine and quetiapine[antipsychotic if hearing voices during the period of dissociation [ before I thought its internalisation] but definitely medication helps [ the million dollar question is how long?]

    - After each moderate to severe self harm behaviours - 1-1 session with a medic/nurse for 5-10 minutes only [medic is better ;)]

    - For all the above rapport is important - esp. being non paternalistic and non judgemental

    - For some having an up to date crisis plan, care plan, risk assessments helps [ for anyone seeing EUPD patients in A&E please consider up to 72 hrs admission- a good learning point for me ] and consider liaise with CCO and CRHT/HTT and definitely have a CRISIS PLAN as individuals might have a opinion of their own, which should be acknowledged and validated and perhaps the right call, but this might not be helpful for the patients with high expressed emotions and emotional instability] this way as medics show a holistic approach to someone's care and as a junior doctor [SpR] taking leadership in someone's care

    - Having a care plan like 6 admissions up to 72 hours per year might help with patients who feels the sense of abandonment [ overall this might save public resources taking the police, ambulance times etc...]

    In spite of all we do some might end their life, this is inevitable, but
    - involving the family is paramount in every step
     
    Last edited: Sep 22, 2016

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