13. Mental Health A

Question 1

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What key questions should be asked to screen for depression?

Answer 1

During the last month have you often been feeling down, depressed or hopeless?

During the last month have you had little interest or pleasure in doing things?

Question 2

What are the associated symptoms of depression?

Answer 2

• Sleep
• Appetite and weight
• Fatigue
• Agitation
• Concentration
• Feeling worthless
• Suicidal ideation

Question 3

What scoring systems are used for assessing depression?

Answer 3

PHQ-9
Patient health questionaire 9

HADS
Hospital anxiety and depression scale

BDI-II
Beck Depression Invetory II

Question 4

How should depression be managed generally?

Answer 4

Signposting
- Roycal college of psychiatrists website
- MIND
- Samaritans

Advice for wellbeing

Social support

Urgent referral

Question 5

What SSRI is first line for depression?

Answer 5

Sertraline

Question 6

What is an example of SNRI and when is it used?

Answer 6

Duloxetine

Question 7

What other treatments can be offered for depression?

Answer 7

CBT
Group exercise
Group mindfulness
SSRIs
Counselling
Short-term psychodnamic psychotherapy

Question 8

What is the follow-up for patients started on SSRIs?

Answer 8

Under 30 within 1 week due to higher risk of suicidal ideation

Over 30, 4-6 weeks, depends on severity

Question 9

What can be given for palpitations and sweating?

Answer 9

Propanolol

Question 10

What is given short-term for anxiety?

Answer 10

Benzodiazepines

Pregabalin second line

Question 11

What can be done to deal with anxiety?

Answer 11

Mindfulness exercises
Exercise
Square breathing