Depression | Mental State Examination (MSE) | OSCE Guide | SCA Case | UKMLA | CPSA | PLAB 2 — Transcript

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1. 0:03[Music]
2. 0:18hello I'm Jade I'm one of the doctors
3. 0:21from the Psychiatry team
4. 0:23can I please just check your name and
5. 0:25date of birth
6. 0:27um it's it's
7. 0:29um Jane
8. 0:32Jane Sheraton and um
9. 0:36it's the 3rd of May
10. 0:3968. okay
11. 0:42and I've been told that you've come into
12. 0:44hospital because one of your friends was
13. 0:46worried about your mental health is that
14. 0:48right
15. 0:50yeah yeah
16. 0:52could you tell me a bit about how you've
17. 0:54been feeling
18. 0:57it's very really sad
19. 1:02just
20. 1:04just sad
21. 1:08how long has that been going on for
22. 1:11foreign
23. 1:12a few weeks now
24. 1:17so anything in particular that's been
25. 1:19going on recently
26. 1:24so I I am
27. 1:27I lost my job
28. 1:32you really love that
29. 1:37that sounds really really difficult it
30. 1:40was it is it's really hard
31. 1:46I guess you know that all sounds like a
32. 1:48lot going on
33. 1:51if you've been able to kind of do
34. 1:53anything you enjoy
35. 1:56I I don't do anything any I I don't
36. 2:01enjoy anything I
37. 2:05don't do anything I don't do anything
38. 2:08anymore
39. 2:12it's done
40. 2:16I just
41. 2:18cry I just can't stop crying I just
42. 2:22hmm
43. 2:25kind of things would you have done
44. 2:26before
45. 2:31damn
46. 2:34I don't see friends
47. 2:38I I don't really I don't
48. 2:42I don't have really friends now
49. 2:49I
50. 2:50um I'd quite right
51. 2:52go running but I just don't come can't
52. 2:56don't
53. 2:58just don't have don't have any one or
54. 3:03don't do anything
55. 3:07hey
56. 3:08I hope you've been sleeping
57. 3:12oh
58. 3:14I just slipped really bad because I am
59. 3:19I just keep waking up just
60. 3:24just waking up and just
61. 3:27thinking about
62. 3:30how
63. 3:32how bad I am I've done
64. 3:35I've let I've let so many people down I
65. 3:39just I can't sleep
66. 3:43just let lots of people
67. 3:45[Music]
68. 3:47okay why is everything
69. 3:54I I've lost my job it must be my fault
70. 3:58I've I've left I left the team down and
71. 4:05it's really let my son down
72. 4:09because I
73. 4:11I I have
74. 4:15I've got no more money now and I I
75. 4:19just really want to pay for him
76. 4:24you know for University and I I'm just a
77. 4:28really bad mum because I just can't I
78. 4:30can't afford to no I haven't got a job
79. 4:36just in terms of with the way that
80. 4:39you've been feeling and everything
81. 4:40that's been going on have you been
82. 4:42managing to look after yourself
83. 4:46I just can't
84. 4:47it
85. 4:49just don't see the point
86. 4:53have you been eating
87. 4:56no
88. 5:00no just some mum
89. 5:05it's a bit of toast
90. 5:08oh
91. 5:10okay
92. 5:12sometimes when people have been dealing
93. 5:14with things like this they might try
94. 5:16drugs or alcohol as a way of coping
95. 5:19is that something that you've tried
96. 5:23no
97. 5:25and things ever felt so bad that you've
98. 5:29thought of harming yourself or ending
99. 5:32your life
100. 5:36okay yes
101. 5:40I'm really sorry I'm really sorry I'm
102. 5:43just okay
103. 5:44I'm sorry I know it's a really difficult
104. 5:46thing no I'm just sorry to waste your
105. 5:48time I'm just not worth helping there'll
106. 5:51be other people there's other people
107. 5:53that you should be helping not me I'm
108. 5:55just not worth it
109. 5:57what is it that you've thought about
110. 5:59doing
111. 6:01well I mean I don't know if I'd actually
112. 6:04do it but I am
113. 6:05I I I I am I but I I've been buying
114. 6:11paracetamols
115. 6:14okay I just don't think things are gonna
116. 6:18get any better I just
117. 6:21I just say
118. 6:24did you made any plans to take those
119. 6:27pills
120. 6:29I
121. 6:30um
122. 6:34I I
123. 6:35I don't want to be here but I I
124. 6:39um
125. 6:40I I don't know if if I would but I am
126. 6:45feel so bad that I just
127. 6:48thought I should let me write a note for
128. 6:51my son or
129. 6:54yeah I did think about checking my wheel
130. 7:00I mean I I don't know if I would do it
131. 7:02but I
132. 7:06I think
133. 7:08is there anything that would stop you
134. 7:10from doing something like that
135. 7:16no I
136. 7:20don't think so because I just don't
137. 7:23think anything's going
138. 7:25to have you had any thoughts about
139. 7:27wanting to harm anyone else at any point
140. 7:31no no
141. 7:33have you ever been worried that other
142. 7:36people might be able to hear or
143. 7:39interfere with your thoughts at all
144. 7:42no no
145. 7:44or have you ever been worried that
146. 7:46someone might be controlling your
147. 7:48thoughts or what you do
148. 7:52no no okay
149. 7:54and
150. 7:56to the questions sometimes people have
151. 7:59been feeling the way you do at the
152. 8:01moment they might have seen or heard
153. 8:04kind of abnormal things they can't
154. 8:06explain is that something you've
155. 8:08experienced no no no no no
156. 8:11then just a couple questions and
157. 8:15do you do you know where we are right
158. 8:17now
159. 8:19yeah yeah would you be able to tell me
160. 8:22I'm just
161. 8:23with the a e that my friend brought me
162. 8:27to yeah
163. 8:28and
164. 8:29you know roughly what time it is
165. 8:36and can you remember who I am
166. 8:40um I've forgotten your name but yours
167. 8:41that you're the doctor yeah yeah
168. 8:44I think it's possible that the way
169. 8:46you've been feeling recently might be
170. 8:48affecting your thinking
171. 8:53um
172. 8:55I I know I'm I'm depressed
173. 9:02pot
174. 9:06no I died just
175. 9:09things won't get better
176. 9:12is there anything that you think we
177. 9:14could do to help you that might help you
178. 9:16get through this
179. 9:21I just don't think anyone can help
180. 9:24I don't think anyone can
181. 9:31well thank you very much for speaking to
182. 9:33me today I know that must be really
183. 9:35difficult to talk about
184. 9:37think it'd be best if I go speak with my
185. 9:40team to see what we can do to help you
186. 9:42would that be okay
187. 9:46you got any questions for me at the
188. 9:48moment
189. 9:50no thanks no no
190. 9:53okay well thank you very much for
191. 9:55speaking to me today today I assessed
192. 9:58Jane Sheraton a 48 year old lady
193. 10:00presenting with low mood and suicidal
194. 10:03ideation on a background of significant
195. 10:06social stresses for the last couple of
196. 10:08weeks she has been struggling with
197. 10:10suicidal ideation and has been
198. 10:12stockpiling paracetamol
199. 10:14she states that her friends and family
200. 10:16would be better off without her on
201. 10:19examination she appeared sad and tearful
202. 10:22with poor eye contact and evidence of
203. 10:24psychomotor retardation Jane's speech
204. 10:28was slow and monotonous she described
205. 10:31her mood as low with evidence of
206. 10:33anhedonia poor concentration and early
207. 10:36morning waking her affect was blunted
208. 10:40Jane described mood congruent cognitions
209. 10:43of hopelessness
210. 10:45burdensomeness and guilt her thoughts
211. 10:48were linear and there was no evidence of
212. 10:50formal thought disorder she denied any
213. 10:53perceptual abnormalities Jane was
214. 10:55oriented to time place and person
215. 10:58Jane demonstrated partial Insight but
216. 11:01she does not believe that her cognitions
217. 11:03of guilt or hopelessness could be
218. 11:05related to a mental health disorder in
219. 11:08terms of risk during reports ongoing
220. 11:10thoughts of suicide with plans to take
221. 11:13paracetamol overdose she is at risk of
222. 11:15self-neglect due to struggling with
223. 11:18self-care she denied any thoughts or
224. 11:20intent to harm others
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234. 11:43[Music]