The GP medical training website for everyone, not just Bradford.
Est. 2002

CHAT- trainee        CHAT-trainer        CHAT-TPD

Bradford VTS Online Resources:

Clinical Knowledge

Mental Health




If you have files you would like me to host on here and share with others, OR if you would like to help develop these pages further, then please email me.

Severe Mental Illness (SMI) & Mortality

Did you know...

Did you know that patients with SMI die 15-20 years EARLIER than their peers in the general population.   Mainly due to CVD problems.   Hence ,the annual health check is important in this vulnerable group.   Don’t just screen – intervene!  Do something about these if present…

  • Alcohol and illicit/non-prescribed drug use
  • Obesity management & Obesity prevention
  • Physical inactivity – brief advice, referral to exercise programmes and prescribing.
  • Hypertension
  • Type 2 diabetes – prevention and treatment
  • Lipid modification
  • Current smokers: facilitate smoking cessation through pharmacotherapies,
    intensive behavioural support, and methods such as carbon monoxide
And follow them up!   See how they are getting on.


Compared to the general population, people aged under-75 in contact with mental health services in England have death rates that are :

  • 5 times higher for liver disease
  • 5 times higher for respiratory disease
  • 3 times higher for cardiovascular disease
  • 2 times higher for cancer
Suicide is also an important cause of death in the SMI population. Suicide risk in people with SMI is high following acute psychotic episodes and psychiatric hospitalisation. 

Examples of SMI

  • schizophrenia  – more common in men than women.  In men, it is more common between the ages 16 -24, whereas in women it is similar across all ages
  • bipolar disorder – more common in women than men.  In  men is more common between the ages 35 -44, whereas in women the most common ages of first recording are between 25 and 34
  • Other psychosis – more common in men than women. In men is most common between the ages 16 -24, whereas in women the most common ages of first recording are over 75 years old

Important features in the history

  • If you would like to have a go at adding some “top tips” to this page for this specialty (and have your name displayed proudly with bradfordvts),  please email me –

Important features in the Examination

Red Flags

Memory Assessment Tests & their Limitations

Please look under the DOWNLOADS section above under “memory assessment tests” for the different tests available. 

The Limitations of all memory assessment tests like AMTS, MMS, 6-CIT:

  • These tests DO NOT assess the frontal lobe!  For example, things like frontal lobe dementia (often in younger people), frontal lobe dysfunctions like Wernicke-Korsakoff syndrome.
  • So how do you pick up frontal lobe disorders?    Answer – from relatives mentioning, or you noticing (if you know the patient well) a “coarsening of personality”.  The characteristic coarsening of personality involves things like
          • a loss of social, and sometimes sexual, inhibitions
          • a tendency to irritability, a facile jocularity, and abusiveness.
      • And this leads to…
          • family disruption (violence in the home and marital separation);
          • an increased rate of accidents at home, work and on the road;
          • and increased rates of absenteeism, redundancy, offending and vagrancy.
          • Sexual impotence may also develop.
          • Sometimes, the syndrome of ‘morbid jealousy’ may emerge.
          • May lead to a “Dysexecutive Syndrome” picture.
      • In the case of alcohol-related disorders, this is not necessarily related to acute intoxication.

Please leave a comment if you have a tip, spot an error, spot something missing or have a suggestion for a web resource. And of course, if you have developed a resource of your own, please email it to me to share with others.

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