Lesson 1Medical and neurological mimics of psychiatric presentations: thyroid, B12, infection, head injury, and medication-induced symptomsDis lesson reviews common medical and neurological conditions dat mimic psychiatric syndromes, including thyroid disease, B12 deficiency, infections, head injury, and medication effects, stressing red flags, screening tests, and working with primary care in our local setting.
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 formulationDis lesson outlines basic principles of psychiatric diagnosis, stressing phenomenology, longitudinal course, comorbidity, and cultural context, and teaches structured differential formulation dat prioritizes safety, treatability, and diagnostic uncertainty for Sierra Leone patients.
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 featuresDis lesson details recognition of bipolar spectrum conditions, including subtle hypomania, mixed states, and atypical depression, stressing sleep, energy, and activity changes, course patterns, and key distinctions from unipolar depression and personality disorders.
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 statesDis lesson examines how to differentiate primary psychotic disorders from substance-induced psychosis, delirium, and other acute confusional states, using onset, time course, sensorium, cognition, and associated medical findings to guide urgent management decisions.
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)Dis lesson introduces key structured tools and rating scales for outpatient assessment, including PHQ-9, GAD-7, CAGE, AUDIT, C-SSRS, and YMRS, with guidance on administration, interpretation, limitations, and integration into clinical decision-making in local clinics.
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 diagnosesDis lesson teaches how to construct biopsychosocial formulations dat integrate predisposing, precipitating, perpetuating, and protective factors, and how to weigh primary versus secondary diagnoses to guide treatment sequencing and collaborative care planning.
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 cognitionDis lesson covers recognition of alcohol, benzodiazepine, and opioid use disorders, focusing on intoxication, withdrawal, and chronic effects on mood, anxiety, cognition, and psychosis, and how patterns of use complicate diagnosis and mask primary 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 severityDis lesson clarifies DSM-5 and ICD-11 criteria for Major Depressive Disorder, including required symptoms, duration, specifiers, and severity ratings, and discusses differential diagnosis with grief, adjustment disorder, bipolar depression, and 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 prognosisDis lesson explores how family loading, work stress, bereavement, trauma, poverty, and cultural context shape symptom onset, course, and treatment response, helping clinicians refine diagnostic probabilities, risk estimates, and long-term prognosis in Sierra Leone.
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
