ต้องรู้

Hypothesis testing :   type I  and type II error  

Validity  and   reliability  of  diagnostic test / assessment tools

Descriptive   statistic  : percent,  mean, median,   mode,  range, SD, percentile

Univariate  analysis :  chi-Square test, t-test,  ANOVA, correlation, odd ratio, relative risk

concept of   confident interval,  effect size, number needed to treat

Multivariate analysis : linear regression analysis, multiple regression analysis

Survival  analysis,

ANCOVA

ต้องรู้

ควรรู้

psychosocial therapies

Counseling

Psychoeducation

Psychotherapy

-         Supportive psychotherapy

-         Psychodynamic psychotherapy

-         Cognitive behavioral therapy

-         Satir model systemic psychotherapy

-         Buddhist oriented psychotherapy

-         Crisis intervention

-         Brief psychotherapy

-         Behavior therapy

-         Motivational interview

-         Interpersonal psychotherapy

-         Rehabilitation technique

-         Group psychotherapy

-         Psychosocial intervention in substance use disorder

-         Play therapy

-         Family therapy

-         Marital therapy

-         Milieu therapy

ต้องรู้

ควรรู้

somatic treatment methods

Electroconvulsive therapy (ECT)

rTMS

Biofeedback

Light therapy

Alternative medicine (eg. Acupuncture, massage)

ต้องรู้

ควรรู้

1.1               Specific syndrome (e.g. stress reactions, postpartum disorders, pain syndrome, postsurgical and  ICU reactions, obesity)

Stress  reactions

-Physiological response to stress (neurotransmitter response, endocrine responses, psychoneuro-immunology )

- Stress and psychiatric illness

- Treatment ;-  Pharmacological  approach,  Cognitive- behavioral  approach              

Postpartum  disorder

-Postpartum  psychiatric  disorders

(postpartum depression, postpartum psychosis, fetal alcohol syndrome) : clinical  feature, risk  factors, course  and  prognosis, management

-Psychopharmacology during pregnancy  and lactation

Pain  syndrome

- Etiology  

- Psychopathology and  psychodynamic  theme

- pain  behavior, suffering  and psychiatric  diagnosis  (depression, anxiety,                  somatoform disorder)

-  pain  management

Organ  Transplantation

- transplant  donor

- transplant  recipient

-  assessment  of  psychosocial factor, health behavior, compliance, social support,  prior coping, disease– specific  coping

- psychiatric  diagnoses

-  contraindication of  organ transplantation

Hemodialysis

-         psychiatric problems ; dependence, regression, hostility

Obesity

- Definition

- Etiology

- Risk factor: genetic  risk, behavioral  risk, illness risk

- Social & psychological consequence

- Treatment ;   behavior therapy

1.2   Psychiatric  aspects  of nonpsychiatric illness  (Epidemiology,  Etiology,

clinical feature and  diagnosis, course and prognosis,    treatment)

    -   mood, anxiety and  psychotic symptom,  delirium due to medications

    -  common medical drugs that relate to psychiatric symptoms ;

    - corticosteroid,  anticancer  agents, interferon, antihypertensive drugs, etc

- drugs abuse ;  analgesics

- sexual dysfunction ; antihypertensive, antiparkinsonian agents

1.3   Psychosomatic  and somatopsychic disorders.

    - definition  &  concept

    - classification  in  DSM-IV TR/ ICD- 10  and  diagnosis

    -  etiology;

·          stress  factors ; specific, nonspecific

·          physiological  factors  [ Hans Selye (general adaptation  syndrome), George  Engel, Walter Cannon (fight or flight response) ]

    -  treatment ; collaborative approach

-Conditions mimicking psychosomatic disorder

- Alternative therapy ; acupressure, acupuncture

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ควรรู้

1.4   models  of  consultation psychiatry

    - definition  &  concept of consultation psychiatry, consultation –liaison psychiatry

    - concept of biopsychosocial model

    -  role and  task            

1.5   Areas to be covered in a consultation including 

    - coping with illness

    -  death, dying  and bereavement

    -  dealing with noncompliance or refusal to consent to procedure

    - psychotherapy of the medically ill

- alternative or complimentary medicine ; herbal preparation with psychotropic effects

ต้องรู้

ควรรู้

Rights of Patients   

-         Involuntary Hospitalization

-         Responsibility to Disclose

-         Responsibility to Appeal

-         Responsibility to Treat

-         Responsibility to Cooperate With Utilization Review

-         Boundary Violations

-         Confidentiality

 -      Breach of Confidentiality

Psychiatric Malpractice

-         Malpractice Claims

-         Somatic Therapies—Standard of Care

-         Somatic Therapies—Legal Liabilities

-         Failure to Evaluate Properly

-         Failure to Monitor or Supervise

-         Negligent Prescription Practices

-         Split Treatment

-         Violent Patients

Sexual Misconduct

-         Sexual Exploitation: Legal and Ethical Consequences

-         Criminal Sanctions

-         Licensure and Ethical Codes

Testimonial Privilege

-         Exceptions to Testimonial Privilege

-         Liability

Seclusion and Restraint

-         Indications for Seclusion and Restraint

-         Contraindications to Seclusion and Restraint

Recovered Memories

Competency: A Cornerstone Concept

-         Competency

-         Incompetent

-         Health Care Decision Making

-         Levels of Competency

-         Guardianship

-         Substituted Judgment

-         Physician-Assisted Suicide

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Criminal Proceedings

-         Competency to Stand Trial

-         Insanity Defense

-         Automatisms

-         Guilty But Mentally Ill

Civil Litigation

พระราชบัญญัติสุขภาพจิต พ.ศ.๒๕๕๑

กฎหมายที่เกี่ยวข้องกับสุขภาพและบุคลากรด้านสุขภาพ

ต้องรู้

ควรรู้

      Basic principles in public health

            Foundations of the health and in particular of the mental health system

            Policy issues relevant to psychiatry as well as levels of care

            Access community, national, and allied health professional resources

            Basic macroeconomic theory and its application to the financing of mental health systems

            The relationship between psychiatry, the individual and the national economy

            Organization and the financial aspects of psychiatric services

            Principles of management including financial and human resource management with emphasis in community financing social insurance, user fees, privatization, equity and efficiency improvement

    National decentralized structure and basis for service delivery with respect to psychiatry

    Community systems of care which include ambulatory, consulting, acute care, partial hospital, skilled care, rehabilitation and substance abuse facilities; halfway houses; nursing homes and home care; and hospice organizations and assist patients to access appropriate care and other support services.

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ควรรู้

 –      Quality management of psychiatric

      services

            Use practice guidelines

            Evidence-based mental health

            Time management, clinic scheduling, and efficient communication with referring physicians

            Understanding of risk management

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      Professional Codes  

      Basic Ethical Principles         

      Respect for Autonomy           

      Beneficence                               

      Nonmaleficence       

      The Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry  

      Confidentiality         

      Responsibility to Disclose     

      Responsibility to Appeal       

      Responsibility to Treat           

      Physicians in Training           

      Physician Charter of Professionalism

      บทบาทของแพทยสภา

      จรรยาจิตแพทย์ของสมาคมจิตแพทย์แห่งประเทศไทย

      Health Insurance Portability and Accountability Act  

      Ethics in Managed Care         

      Impaired Physicians                

      Responsibility to Cooperate with Utilization Review  

      Justice                                         

      Sexual Boundary Violations                 

      Nonsexual Boundary Violations          

      Business                      

      Ideological Issues    

      Social                                          

      Financial

ทักษะทางจิตเวช

ทักษะที่จำเป็นต้องทำได้ด้วยตนเอง

ทักษะที่ควรทำได้หรือส่งปรึกษาผู้อื่นได้

ทักษะที่อาจทำได้หรือเลือกส่งปรึกษาผู้อื่นได้เหมาะสม

ทักษะการประเมิน

(Assessment)

Psychiatric interview and assessment (clinical and psychometric evaluation เช่นTMSE, MoCA, CIWA), Basic Child psychiatric  assessment

Physical and neurological examination and history taking

1.       แปลผล Organic test ได้ เช่น ADAS-cog  เป็นต้น

2.       แปลผล Psychiatric rating scale (HAMD, PANSS etc.)

1.      Psychological test (projective test, IQ  test)

2.      Neuro-psychological test

ทักษะการรักษา(Therapeutic  skills)

ทักษะทางจิตเวช

1.       Counseling

2.       Psychoeducation

3.       Psychophamacotherapy

4.       Psychotherapy

      Crisis intervention

      Supportive psychotherapy

      Brief psychotherapy

      Psychodynamic psychotherapy

ทักษะที่จำเป็นต้องทำได้ด้วยตนเอง

ทักษะที่ควรทำได้หรือส่งปรึกษาผู้อื่นได้

1.Buddhist oriented psychotherapy

2.Family therapy

3.Marital therapy

4.Milieu therapy

5.Play therapy

6.Rehabilitation technique

7.Repeated Transcranial Magnetic Stimulation (rTMS)

ทักษะที่อาจทำได้หรือเลือกส่งปรึกษาผู้อื่นได้เหมาะสม

       Motivational interview

      Psychotherapy combined with psychopharmacotherapy

5.       Electroconvulsive therapy

6.       Parental guidance and child discipline technique

1. Cognitive behavioral therapy, Behavior therapy

2.Group psychotherapy

3.Interpersonal psychotherapy

4.Psychosocial intervention in substance use disorder

5.Satir model systemic psychotherapy

ทักษะทางจิตเวชอื่นๆ

- ทักษะการรับปรึกษา Consultation –liaison techniques (communication, professionalism, holistic approach, decision making, system-based skill)

- ทักษะทางนิติจิตเวช(Forensic psychiatric skill)  ได้แก่ การออกเอกสารรับรอง  การเป็นพยาน

- ทักษะทางจิตเวชชุมชน (Community psychiatry)

- ทักษะทางนิติจิตเวช (Forensic psychiatric skill)