MBBS Psychiatry Syllabus

Psychiatry syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Psychiatry in MBBS, not a summary of it.

1. 1

   Introduction to Psychiatry

   2 topics

   • History of psychiatry
     • Evolution of psychiatric concepts and treatments
   • Mental health and illness
     • Definition
     • Stigma
     • Determinants of mental health
2. 2

   Psychological Assessment

   3 topics

   • Mental status examination
     • Appearance
     • Behavior
     • Speech
     • Mood
     • Affect
     • Thought content
     • Thought process
     • Cognition
     • Insight
   • Psychiatric history taking
     • Presenting complaints
     • Personal history
     • Family history
     • Medical history
     • Substance use history
     • Psychiatric treatment history
   • Psychometric assessment
     • Screening tools (PHQ-9, GAD-7, AUDIT, CAGE)
     • Standardized rating scales (HAM-D, MADRS, PANSS)
3. 3

   Psychiatric Disorders

   6 topics

   • Mood disorders
     • Major depressive disorder
     • Bipolar disorder
     • Dysthymia
     • Cyclothymia
     • Mood disorder due to a medical condition or substance
   • Anxiety disorders
     • Generalized anxiety disorder
     • Panic disorder
     • Social anxiety disorder
     • Specific phobias
     • Obsessive-compulsive disorder
   • Psychotic disorders
     • Schizophrenia
     • Schizophreniform disorder
     • Schizoaffective disorder
     • Delusional disorder
     • Brief psychotic disorder
   • Substance-related disorders
     • Alcohol use disorder
     • Opioid use disorder
     • Stimulant use disorder
     • Cannabis use disorder
     • Tobacco use disorder
   • Neurodevelopmental disorders
     • Attention-deficit/hyperactivity disorder (ADHD)
     • Autism spectrum disorder (ASD)
     • Intellectual disability
     • Specific learning disorders
   • Personality disorders
     • Borderline personality disorder
     • Antisocial personality disorder
     • Narcissistic personality disorder
     • Obsessive-compulsive personality disorder
4. 4

   Somatoform and Dissociative Disorders

   2 topics

   • Somatoform disorders
     • Somatization disorder
     • Conversion disorder
     • Hypochondriasis
     • Somatic symptom disorder
   • Dissociative disorders
     • Dissociative amnesia
     • Dissociative fugue
     • Depersonalization/derealization disorder
     • Dissociative identity disorder
5. 5

   Eating Disorders

   3 topics

   • Anorexia nervosa
     • Clinical features
     • Medical complications
     • Nutritional rehabilitation
     • Psychotherapy
   • Bulimia nervosa
     • Clinical features
     • Medical complications
     • Cognitive-behavioral therapy
     • Pharmacotherapy
   • Binge-eating disorder
     • Clinical features
     • Medical complications
     • Psychotherapy
     • Pharmacotherapy
6. 6

   Sleep Disorders

   3 topics

   • Insomnia disorder
     • Difficulty falling asleep
     • Difficulty staying asleep
     • Non-restorative sleep
     • Sleep hygiene
     • Cognitive-behavioral therapy for insomnia
   • Sleep-related breathing disorders
     • Obstructive sleep apnea
     • Central sleep apnea
     • Continuous positive airway pressure
     • Weight loss
   • Parasomnias
     • Nightmare disorder
     • Sleep terror disorder
     • Sleepwalking disorder
     • REM sleep behavior disorder
7. 7

   Sexual Disorders

   3 topics

   • Sexual dysfunctions
     • Erectile dysfunction
     • Premature ejaculation
     • Female sexual interest/arousal disorder
     • Genito-pelvic pain/penetration disorder
   • Paraphilic disorders
     • Exhibitionism
     • Voyeurism
     • Fetishism
     • Pedophilia
     • Sexual masochism/sadism
   • Gender dysphoria
     • Incongruence between assigned gender and experienced gender
     • Clinical features
     • Psychosocial support
     • Hormone therapy
     • Gender-affirming surgery
8. 8

   Geriatric Psychiatry

   3 topics

   • Dementia
     • Alzheimer's disease
     • Vascular dementia
     • Lewy body dementia
     • Frontotemporal dementia
     • Management (cholinesterase inhibitors, memantine)
   • Delirium
     • Clinical features
     • Etiology (infection, medication, metabolic disturbances)
     • Management (identifying and treating underlying causes)
   • Late-life depression
     • Clinical features
     • Risk factors
     • Management (antidepressant medications, psychotherapy, electroconvulsive therapy)
9. 9

   Child and Adolescent Psychiatry

   4 topics

   • Attention-deficit/hyperactivity disorder (ADHD)
     • Clinical features
     • Diagnosis (DSM-5 criteria)
     • Management (stimulant medications, behavioral therapy)
   • Autism spectrum disorder (ASD)
     • Core features
     • Diagnosis (DSM-5 criteria)
     • Management (behavioral interventions, social skills training)
   • Conduct disorder
     • Clinical features
     • Diagnostic criteria (DSM-5)
     • Management (parent management training, cognitive-behavioral therapy)
   • Pediatric anxiety disorders
     • Separation anxiety disorder
     • Generalized anxiety disorder
     • Social anxiety disorder
     • Management (cognitive-behavioral therapy, selective serotonin reuptake inhibitors)
10. 10

    Legal and Ethical Issues in Psychiatry

    3 topics

    • Mental health legislation
      • Involuntary hospitalization
      • Capacity to consent
      • Confidentiality
    • Ethical principles in psychiatry
      • Autonomy
      • Beneficence
      • Nonmaleficence
      • Justice
    • Forensic psychiatry
      • Assessment of competency
      • Criminal responsibility
      • Civil commitment

Psychiatry flashcards for MBBS

21 of 51 cards from the Psychiatry deck — real questions with worked answers.

1. Who is often regarded as the founder of modern descriptive psychiatry, known for distinguishing dementia praecox from manic-depressive illness?

   Emil Kraepelin. He introduced a classification system separating dementia praecox (later renamed schizophrenia by Eugen Bleuler) from manic-depressive (mood) disorders, forming the basis of modern psychiatric nosology.

2. What reform did Philippe Pinel introduce to the history of psychiatry?

   Pinel championed the 'moral treatment' of the mentally ill and is famous for unchaining patients at the Bicetre and Salpetriere asylums in Paris, promoting humane, non-restraint care in the late 18th century.

3. In psychiatry, how is 'mental health' defined by the WHO?

   A state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to his or her community.

4. What are the two major international classification systems used to diagnose mental illness?

   The DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, 5th edition, American Psychiatric Association) and the ICD-11 (International Classification of Diseases, WHO).

5. List the main components (headings) assessed in the Mental Status Examination (MSE).

   Appearance and behaviour; Speech; Mood and affect; Thought (form/process and content); Perception; Cognition; Insight; and Judgement.

6. In the MSE, what is the difference between 'mood' and 'affect'?

   Mood is the patient's sustained, subjectively reported emotional state ('the climate'); affect is the examiner's objective observation of the patient's moment-to-moment emotional expression ('the weather'), assessed for range, appropriateness, and congruence.

7. In thought form, define 'flight of ideas' and contrast it with 'loosening of associations.'

   Flight of ideas is rapid speech with logically/phonetically connected ideas jumping between topics (typical of mania). Loosening of associations (derailment) is a shift between unrelated ideas with no logical connection (typical of schizophrenia).

8. What is the difference between an illusion and a hallucination?

   An illusion is a misperception of a real external stimulus. A hallucination is a perception occurring in the absence of any external stimulus, experienced as real and originating in external space.

9. Define 'insight' as assessed in the MSE.

   Insight is the patient's awareness and understanding that they have a mental illness, its nature, and the need for treatment. It is graded from complete denial of illness to true emotional insight with willingness to act on it.

10. What are the essential components of a comprehensive psychiatric history?

    Identifying data; presenting complaint and history of present illness; past psychiatric history; past medical history; drug/treatment history; family history; personal (developmental) history; premorbid personality; and substance use history.

11. What is meant by 'premorbid personality' in psychiatric history taking?

    A description of the patient's habitual personality, attitudes, relationships, interests, mood, character and coping style before the onset of the current illness, used as a baseline to gauge change.

12. In psychometric assessment, what does an IQ score represent and what is the population mean and standard deviation?

    IQ (Intelligence Quotient) measures cognitive ability relative to age peers. On standard scales (e.g., Wechsler) the mean is $100$ with a standard deviation of $15$, so about $68\%$ of people score between $85$ and $115$.

13. Name two screening rating scales commonly used for depression severity.

    The Hamilton Depression Rating Scale (HAM-D, clinician-rated), the Beck Depression Inventory (BDI, self-rated), and the PHQ-9 (Patient Health Questionnaire-9, self-rated).

14. What is the Mini-Mental State Examination (MMSE) used for and what is its maximum score?

    The MMSE is a brief bedside cognitive screening tool assessing orientation, registration, attention/calculation, recall, language and visuospatial ability. The maximum score is $30$; a score below $24$ commonly suggests cognitive impairment.

15. What distinguishes Major Depressive Disorder from Persistent Depressive Disorder (dysthymia)?

    MDD requires $\geq 5$ symptoms (including depressed mood or anhedonia) for $\geq 2$ weeks. Persistent depressive disorder is chronic low-grade depressed mood for $\geq 2$ years (1 year in children) with fewer symptoms but greater chronicity.

16. State the DSM-5 minimum symptom and duration criteria for a Major Depressive Episode.

    At least 5 of 9 symptoms present nearly every day for $\geq 2$ weeks, with at least one being depressed mood or loss of interest/pleasure (anhedonia). Symptoms cause significant distress/impairment and are not due to another cause.

17. List the 9 symptoms of a Major Depressive Episode (mnemonic SIGECAPS plus mood).

    Depressed mood, plus: Sleep change, loss of Interest (anhedonia), Guilt/worthlessness, low Energy, poor Concentration, Appetite/weight change, Psychomotor agitation/retardation, Suicidal ideation.

18. What defines a manic episode and how does it differ from hypomania?

    A manic episode is $\geq 1$ week of elevated/irritable mood plus increased energy with $\geq 3$ (or 4 if irritable) symptoms, causing marked impairment, psychosis, or hospitalization. Hypomania lasts $\geq 4$ days, has no marked impairment, no psychosis, and no hospitalization.

19. Differentiate Bipolar I from Bipolar II disorder.

    Bipolar I requires at least one full manic episode (depressive episodes common but not required). Bipolar II requires at least one hypomanic episode and at least one major depressive episode, with no history of a full manic episode.

20. What is the first-line mood stabilizer for bipolar disorder, and what is its therapeutic serum range?

    Lithium. The therapeutic serum level for maintenance is approximately $0.6$ to $1.0\,\text{mmol/L}$ (up to $\sim 1.2$ in acute mania); toxicity occurs above $\sim 1.5\,\text{mmol/L}$.

21. What are the core diagnostic features of Generalized Anxiety Disorder (GAD)?

    Excessive, difficult-to-control worry about multiple events occurring more days than not for $\geq 6$ months, plus $\geq 3$ of: restlessness, fatigue, poor concentration, irritability, muscle tension, and sleep disturbance.

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