Depression

Question 1

What classification is used for severity of depressive disorder?

Answer 1

ICD-10 classification

Question 2

What is the required time for diagnosis of depression?

Answer 2

2 weeks

Question 3

What must not happen to be diagnosed with depressive disorder?

Answer 3

Must not have manic episodes

Question 4

ICD-10 mnemonic?

Answer 4

DEAD SWAMPS

Question 5

What does DEADSWAMPS stand for?

Answer 5

D - depressed - core
E - energy low - core
A - anhedonia - core
D - dead thoughts
S - sleep disturbances
W - worthlesseness/guilt
A - appetite
M - mentition
P - psychomotor agitation/retardation

Question 6

What is considered MILD ICD-10 depression?

Answer 6

2 core + 2 extra

Question 7

Moderate depression?

Answer 7

2 core + 4 extra

Question 8

Severe?

Answer 8

3 core + 5 extra OR

any depression with psychosis

Question 9

Investigations for depression?

Answer 9

FBC
- Anaemia

TFTs
- Exclude hypothyroidism

Question 10

DDx?

Answer 10

Seasonal affective disorder

Bipolar (depressive cycle)

Dysthimia/cyclothymia

Metabolic

• Hypothyroid
• Addisons

PCOS

Infections

Question 11

1st line treatments mild - moderate depression?

Answer 11

SSRI
+
CBT referral

Question 12

How can treatment be modified if SSRI doesn’t work?

Answer 12

Swap SSRI

Add SNRI
- Mirtazipine

Change antidepressant class

• TCA
• MOAIs last line

Question 13

What psychotherapies exist for depression?

Answer 13

CBT
IPT
Motivational interviewing

Question 14

What treatment exist for severe depression that has resisted medications and psychotherapy?

Answer 14

ECT
Psychosurgery
Deep brain stimulation
Vagus nerve stimulation

Question 15

What are the 4 aspects of psychiatry?

Answer 15

Persistence of symptoms
Pervasivessness of symptoms
Degree of impairment
Presence of specific symptoms