Depression and Suicide

Question 1

Define dysthymia

Answer 1

sub-threshold symptoms of major depression that lasts at least 2 years

Question 2

What are the principles of assessment of depression?

Answer 2

• degree of functional impairment
• disability associated with possible depression
• duration of episode
• number and severity of symptoms
• course of illness

Question 3

What are the key and associated symptoms of depression?

Answer 3

Key (at least 1 for most of of the time, most days for at least 2 weeks):

• persistent sadness/low mood
• marked loss of itnerests/pleasure (anhedonia)

Associated:

• disturbed sleep
• change in appetite/weight
• fatigue/loss of energy
• agitation
• poor concentration
• feeling worthless
• feeling inappropriately guilty
• suicidal thoughts/acts

Question 4

What are the risk factors of depression?

Answer 4

• genetic and family (if first-degree relative has it)
• early life experiences (poor parent-child relationship, marital problems, neglect, abuse)
• early childhood loss (esp. loss of mother)
• stressful life events

Question 5

Describe the relationship between depression and chronic illness

Answer 5

• chronic illness increases the risk of depression
• depression can exacerbate the pain/distress associated with physical illness
• it can cause an individual to pick up unhealthy behaviours and affect their adherence to treatment and medicine

Question 6

What is the psychological approach to treatment?

Answer 6

• CBT (identifies and challenges unhealthy modes of thinking that caused depressed feelings and behaviour)
• CCBT
• structured group physical activity programme

Question 7

What are the factors impacting suicidal behaviour?

Answer 7

• health system (access to, stigma)
• community/relationships (war, discrimmination, abuse)
• individual (previous attempt, mental disorder, alcohol abuse, chronic pain)

Question 8

What are the principles of a suicide risk assessment?

Answer 8

• ask directly about suicidal ideation/intent
• assess if individual has adequate social support and is aware of sources of help
• arrange help appropriate to the level of risk
• advise person to seek further help if it deteriorates