Depression

Question 1

What are the core symptoms of depression?

Answer 1

FLIPS

Fatigue
Loss of Interest (anhedonia)
Peristent Sadness (depressed mood)

For 2 weeks

Question 2

What are the other symptoms of depression?

Answer 2

SIGECAPS

Sleep
Irritability
Guilt
Esteem
Concentration
Appetite
Positivity
Suicidal thoughts

Question 3

How do you grade depression

Answer 3

NO MOOD ELEVATIONS

2 core + 2 others = MILD
2 core + 3-4 others = MODERATE
2 core + 4 others severe = SEVERE

Below 4 symptoms = DSYTHYMIA

Question 4

What is the treatment ladder for depression?

Answer 4

Patient education e.g. sleep hygeine
CBT, CCBT, group CBT etc
Intense CBT e.g. 16-20 in 3 months
SSRI
Switch to another SSRI
Switch to a TCA / atypical
Combination therapy / augmentation
Augmentation with an antipsychotic 
ECT

Question 5

Patient presents with:

a: - Persistent subthreshold depression
b: - Mild to moderate depression
c: - Mild to moderate depression refractory to prev tx
d: - Moderate to severe depression
e: - Severe depression

Answer 5

a: - Persistent subthreshold depression

CBT, CCBT, group CBT, sleep hygeine

b: - Mild to moderate depression

CBT, CCBT, group CBT, sleep hygeine

c: - Mild to moderate depression refractory to prev tx

SSRI, high intensity CBT

d: - Moderate to severe depression

SSRI, high intensity CBT

e: - Severe depression

SSRI, referral to MHS

Question 6

When might you use ECT?

Answer 6

Refractory depression
Attempted suicide
Strong suicidal plans
Marked psychomotor retardation
Delusions / hallucinations

Question 7

Depression affects…

Answer 7

F>M 3:1

Question 8

Acute treatment of bipolar?

Answer 8

Benzos / antipsychotics

Question 9

Maintenance of bipolar

Answer 9

Lithium

Question 10

What are the positive signs of schiz?

Answer 10

1 OF THESE TO DIAGNOSE SCHIZ:

ABCDE

Auditory hallucinations 3rd person
Broadcasting - thought
Control, delusions of 
Delusional perception
Thought echo

Question 11

What are the negative signs of schiz?

Answer 11

Apathy (interest)
Alogia (speech)
Avolition (motive)
Affective blunting (intensity of emotional response)
Anhedonia (pleasure)
Amotivation

Question 12

Eating disorders affect…

Answer 12

F>M 10:1!

Question 13

Schizophrenia and bipolar affect…

Answer 13

M=F

M onset = late teens
F onset = 20s

Question 14

Anorexia tx?

Answer 14

Controlled weight gain

Question 15

Builimia tx?

Answer 15

SSRIs, CBT

Question 16

Risk of future suicide attempt in suicide?

Answer 16

15% in 1 year

1% success