Depression

Question 1

How many cases a year and prevalence
Female to male
Age

Answer 1

1.6 per 100
2.6 a-15%
Two to one female to male
Nid 30s but increasing in younger pop and common in elders

Question 2

Causes

Answer 2

Negative affect- low mood
Loss of positive affect so loss of interest and pleasure
Assortment of emotions due to social physical behaviour symptoms

Question 3

Risk factors

Answer 3

Adverse life events e.g injury, bereavement
Stress
Female
Physical disability
Past medical history
More common in Afro Caribbean Asian and asylum Seekers
Bypofunction of monoamine neurotransmitter system

Question 4

Core three

Answer 4

Loss if interest
Loss of energy
Low mood

Question 5

Symptoms

Answer 5

Loss of interests 
Loss of emotional reactivity 
Insomnia 
Surinam variation of mood 
Loss of appetite and thus weight loss 
Loss of libido and amenorrhea 
Indecisiveness 
Poor self esteem 
Hopeless self worthlessness 
Self haram and suicidal thoughts 
Poor concentration level 
Amenorrhoea

Question 6

What are key questions to ask

Answer 6

How long have you been feeling like this
Why
Ask about sucidal thoughts
Consider patient safety and risk to other

Question 7

What drugs can cause depression

Answer 7

Propranolol

Benzodiazepines

Methylopa

Question 8

Differentials

Answer 8

Bipolar
Dementia
Bereveanmentn
SAD

Question 9

Investigations

Answer 9

History
Past medical history include psychiatric history
PHQ9
Hospital anxiety assessment

Question 10

Treatment for mild to

Moderate

Answer 10

Watch and reassess
Consider CBT and relaxation therapy
Consider lifestyle changes

Question 11

Long term treatment for severe depression

Answer 11

SSRI- sertaline
Amitrypline
MOAI