Depression

Question 1

Depression Diagnosis

Answer 1

One of:

• Persistent sadness or low mood
• Loss of interest

Three/Four of:

• Fatigue
• Poor sleep
• Changed appetite
• Poor concentration
• Psychomotor agitation
• Guilt
• Change in libido

Must not be caused by organic factor or illness

Severity

• Subthreshold: <5 symptoms
• Mild: Few, around 5
• Moderate: between 5 and most
• Severe: most symptoms

Question 2

Depression RFs

Answer 2

• Female gender
• PHx
• Chronic illness
• Other mental health problems
• Psychosocial problems

Question 3

Depression Assessment

Answer 3

• PHQ-9

- HAD

Question 4

Depression Differentials

Answer 4

• Bipolar
• Schizophrenia
• Dementia
• SAD

Question 5

Depression Ix

Answer 5

• Exclude organic causes

- Investigation not mandatory

Question 6

Depression Management

Answer 6

• CBT first
• Antidepressants are not recommended for initial management for mild
• In moderate to severe depression give antidepressants alongside CBT
• Continue antidepressants for 6 months after remission
• Reduce dose gradually over 4 weeks