Lesson 1Medical and neurological mimics of psychiatric presentations: thyroid, B12, infection, head injury, and medication-induced symptomsThis lesson examines common medical and neurological conditions that resemble psychiatric disorders in Botswana settings, such as thyroid problems, B12 deficiency, infections, head injuries, and drug side effects, highlighting warning signs, tests, and teamwork with general doctors.
Endocrine causes: thyroid, adrenal, and metabolic issuesNutritional and hematologic factors, including B12Infections, inflammation, and systemic illness effectsHead injury, seizures, and neurodegenerative diseaseMedication- and substance-induced psychiatric symptomsIndications for labs, imaging, and specialist referralLesson 2Principles of psychiatric diagnosis and differential formulationThis lesson covers basic rules of psychiatric diagnosis in Botswana, focusing on symptom descriptions, illness progression, co-existing conditions, and cultural influences, while teaching structured ways to differentiate diagnoses, prioritising safety and treatability.
Phenomenological description of symptoms and signsLongitudinal course and life-stage considerationsComorbidity and overlapping symptom clustersCultural formulation and explanatory modelsPrioritizing safety and treatable conditions firstCommunicating diagnostic uncertainty to patientsLesson 3Bipolar spectrum and bipolar depression: signs suggesting hypomania/mania, sleep and activity changes, and differential featuresThis lesson explains how to spot bipolar conditions in Botswana patients, including mild hypomania, mixed episodes, and unusual depression, stressing changes in sleep, energy, activities, patterns over time, and differences from single-episode depression or personality issues.
Clinical features of hypomania and maniaSleep, circadian rhythm, and activity pattern changesCourse patterns: episodicity, polarity, and seasonalityDifferentiating bipolar from unipolar depressionMixed features and rapid cycling presentationsScreening tools and collateral history for bipolarityLesson 4Primary psychotic disorders vs substance/withdrawal-induced psychosis and acute confusional statesThis lesson helps distinguish true psychotic disorders from those caused by substances, withdrawal, or confusion in Botswana contexts, using onset timing, awareness levels, thinking ability, and medical checks to make quick management choices.
Core features of schizophrenia spectrum disordersTemporal relationship between substance use and psychosisRecognizing delirium and fluctuating consciousnessCognitive testing and attention in acute confusionMedical workup for first-episode psychosisRisk assessment and need for urgent hospitalizationLesson 5Structured diagnostic tools and rating scales useful in outpatient assessment (PHQ-9, GAD-7, CAGE/AUDIT, C-SSRS, YMRS)This lesson introduces essential tools like PHQ-9, GAD-7, CAGE, AUDIT, C-SSRS, and YMRS for clinic assessments in Botswana, covering how to use them, interpret results, note limits, and apply to patient decisions.
Selecting appropriate screening and rating instrumentsUsing PHQ-9 and GAD-7 in routine assessmentCAGE and AUDIT for alcohol use identificationC-SSRS for suicide risk screening and monitoringYMRS and other mania rating scalesDocumenting and tracking scores over timeLesson 6Formulating multi-factorial etiologies: biopsychosocial integration and weighing primary versus secondary diagnosesThis lesson teaches building full biopsychosocial explanations in Botswana, including risk factors, triggers, ongoing issues, and strengths, and deciding main versus related diagnoses to plan treatments and teamwork.
Predisposing, precipitating, perpetuating, protective modelBiological factors: genetics, neurobiology, medical illnessPsychological factors: traits, coping, trauma, beliefsSocial factors: relationships, work, culture, resourcesWeighing primary versus secondary diagnosesLinking formulation to treatment and prognosisLesson 7Substance use disorders and pattern recognition: alcohol, benzodiazepines, and opioids effects on mood and cognitionThis lesson addresses spotting alcohol, benzodiazepine, and opioid issues in Botswana, covering intoxication, withdrawal, long-term mood, anxiety, thinking, and psychosis effects, and how use patterns hide main disorders.
Screening for alcohol, benzodiazepine, and opioid useIntoxication syndromes and acute behavioral changesWithdrawal states and rebound anxiety or agitationSubstance-induced mood and cognitive symptomsDistinguishing primary from substance-induced disordersAssessing severity, tolerance, and functional impactLesson 8Diagnostic criteria for Major Depressive Disorder (DSM-5 / ICD-11): core symptoms, specifiers, duration, and severityThis lesson clarifies DSM-5 and ICD-11 rules for major depression in Botswana, including key symptoms, length, types, severity, and differences from grief, adjustment issues, bipolar, or medical causes.
Core mood, cognitive, and somatic symptomsDuration, impairment, and exclusion criteriaSpecifiers: melancholic, atypical, psychotic, anxiousSeverity assessment: mild, moderate, severeDifferentiating MDD from grief and adjustment disorderDistinguishing MDD from bipolar and medical causesLesson 9How family history, occupational stressors, relationship loss, and social determinants modify diagnostic probability and prognosisThis lesson explores in Botswana how family background, job stress, loss of relationships, trauma, poverty, and culture affect symptom start, progress, and treatment success, aiding better diagnosis, risk, and outlook predictions.
Eliciting detailed family psychiatric and substance historyAssessing occupational stress, burnout, and job insecurityImpact of bereavement, separation, and attachment lossSocial determinants: housing, income, discrimination, migrationCultural and religious factors in symptom expressionIntegrating contextual risks into prognosis and planning
