depression

Question 1

what is depression

Answer 1

at least 2 weeks of anhedonia, low mood and low energy most days

Question 2

is depression more common in females or males

Answer 2

females
2:1

Question 3

are men more suicidal or women

Answer 3

men

Question 4

what is psuedodementia

Answer 4

cognitive and functional impairments that mimic dementia but are secondary to depression

lots of ‘i dont know’ answers

Question 5

biological risk factors for depression

Answer 5

chronic pain
post partum
steroids
decreased T4

Question 6

psycholgical risk factors for depression

Answer 6

trauma
low self esteem
abuse

Question 7

social risk factors for depression

Answer 7

bereavement
divorce
stress

Question 8

what is the stress vulnerability model

Answer 8

different people have different thresholds before spiraling

Question 9

what is the monoamine hypothesis

Answer 9

suggests neurotransmitters are indicated in depression
low serotonin, low dopamine, low noradrenaline

Question 10

symptoms of depression

Answer 10

SIGE CAPS
suicide/self harm
interest low
guilt + worthlessness
energy low
concentration low
appetite low
psychomotor retardation
sleep low

Question 11

what is atypical depression

Answer 11

high appetite
high sleep
high mood on good occasions
catatonia
very sensitive

Question 12

treatment for aytpical depression

Answer 12

treatment is CBT+MAOI

Question 13

what bloods do you do for depression

Answer 13

FBC
U+E
TFT
prolactin
syphillis serology
B12
folate

Question 14

4 questionnaires for depression

Answer 14

PHQ-9 (most common)
HADS (only in hospital)
BD1-11 (self reporting)
Edinburgh (post natal)

Question 15

how to score PHQ - 9

Answer 15

0-4 none
5-9 mild
10-14 moderate
15+ severe

Question 16

how to classify depression for diagnosis

Answer 16

subclinical: less than 4 sigecap sx

mild: more than 5 sigecap sx + little functional impairment

moderate: more than 5 sigecap sx + marked functional impairment

severe: more than 5 sigecap sx + marked functional impairment +/- psychosis

Question 17

treatment for mild depression

Answer 17

1. start with CBT
2. if not working use SSRI

Question 18

treatment for moderate - severe depression

Answer 18

SSRI + high intensity CBT

Question 19

treatment for refractory/severe depression

Answer 19

ECT

Question 20

give 2 subtypes/differentials for depression

Answer 20

seasonal affective disorder

dysthymia

Question 21

what is seasonal affective disorder

Answer 21

recurrent
usually occurs in winter
tx is light therapy and ssri

Question 22

what is dysthymia

Answer 22

subclinical depression for more than 2y
tx is low intensity CBT

Question 23

what is IAPT referral

Answer 23

Improving access to Psych therapy

an NHS initiative for mild-moderate depression

Question 24

2 types of self harm

Answer 24

cutting
head banging

Question 25

risk factors for self harm

Answer 25

LGBTQ female depression bereavement trauma +abuse

Question 26

methods of suicide

Answer 26

cutting ligatures overdose jumping from height

Question 27

risk factors for suicide

Answer 27

SAD PERSONS sex M age - old & teens depressed past history of parasuicide Ethanol (alcohol) rational loss (psychotic) social support low organised plan non married sick - chronic illenss

Question 28

which patients have increased risk of suicide recurrence

Answer 28

- makes concious effort to not be found - leaves note - plans death - no regret afterwards