Depression

Question 1

What 2 questions can be used to screen for depression

Answer 1

during last month have you been feeling down, depressed or hopeless

during the last month have you found little interest or pleasure in doing things

Question 2

What is the hospital anxiety depression scale

Answer 2

HAD

14 questions , 7 for anxiety and 7 for depression

each item score 0-3

score out of 21

Question 3

How do you interpret the HAD scale

Answer 3

0-7 normal
8-10 borderline
11+ severe

Question 4

What is the patient health questionnaire

Answer 4

PHQ-9

9 questions score 0-3
includes asking about suicidal thoughts

Question 5

How do you interpret the PHQ-9 score

Answer 5

depression severity

0-4 none
5-9 mild
10-14 moderate
15-19 moderately severe
20-27 severe

Question 6

What are core symptoms of depression according to DSM4

Answer 6

depressed mood most of day, nearly every day

diminished interest/pleasure in almost all activities

Question 7

What are other symptoms of depression according to DSM-4

Answer 7

appetite/weight change

insomnia/hypersomnia

psychomotor agitation or retardation

fatigue/loss of energy

feelings of worthlessness

diminished ability to concentrate

recurrent thoughts of death/suicide

Question 8

What is management for less severe depression

Answer 8

first line is guided self help

group CBT
SSRI if patient wants

Question 9

How do you manage more severe depresion

Answer 9

Individual CBT and
SSRI or SNRI

Sertraline / fluoxetine/citalopram