Structured Patient Management Problems for the MRCPsych Part II
Sample from the pilot examination

Vignette Number FOR 013

Speciality:

Forensic Psychiatry

Date:

10 October 2001

Vignette:

You are asked to write a court report on a 55 year old man charged with indecent exposure. He has no previous convictions for this.

How would you approach the consultation and what psychiatric diagnosis would you have in mind.

Suggested Probes:

  1. Are there any clinical features, which would increase your level of concern?
  2. What advice are you going to give the court with regard to the risk of re-offending?
  3. What information would you require to complete your report?

 

 

  1. Need to gather information from a range of legal and medical sources prior to completing assessment.
  2. Be aware of particular implications of a man in this age presenting for the first time.
  3. Possible psychiatric diagnoses include organic brain syndrome, e.g., frontal lobe dementia, hypomania, depression and substance abuse.
  4. Possible association of indecent exposure with other more serious sexual offending (e.g., if penis erect during exposure, if escalating behaviour).
  5. The low actuarial risk of an individual re-offending (low risk of re-offending if no previous offences of this nature).
© 2007 Royal College of Psychiatrists