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Mental Health > Depression and Suicide > Flashcards

Depression and Suicide Flashcards

1
Q

What is the scoring system for deciding on someone’s depressive state?

A

ICD-10

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2
Q

What are the key symptoms of depression that is in the ICD-10?

A
  1. Persistent low mood
  2. Loss of interest or pleasure
  3. Fatigue/low energy
  4. Disturbed sleep
  5. Poor concentration or indecisivness
  6. Low self confidence
  7. Poor or increased appetite
  8. Suicidal thoughts/acts
  9. Agitation or slowing of movements
  10. Guilt/self blame
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3
Q

If the ICD-10 had the following score, what sort of depression would someone have; 4?

A

Mild Depression

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4
Q

If the ICD-10 had the following score, what sort of depression would someone have; 5-6?

A

Moderate depression

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5
Q

If the ICD-10 had the following score, what sort of depression would someone have; 7+?

A

Severe depression (+/-psychotic symptoms)

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6
Q

What is the major depressive score?

A

DSM-5

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7
Q

What are the symptoms listed on the DSM-5 score?

A

MUST HAVE
1. Depressed mood OR
2. Markedly diminished interest or pleasure in all activities
NEED 3+ OF THE FOLLOWING
3. Poor or increased appetite
4. Insomnia or hypersomnia
5. Psychomotor agitation or retardation
6. Fatigue/loss of energy
7. Feelings of worthlessness or inappropriate guilt
8. Diminished ability to think or concentrate
9. recurrent thoughts of death or suicide

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8
Q

Define Hypomania

A

A distinct period of abnormally and persistently elevated, expansive or irritable mood.
Persistently and abnormally increased activity or energy lasting at least 4 CONSECUTIVE DAYS, present for most of the day nearly every day.

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9
Q

What symptoms must also be present in hypomania and mania (at least 3-4)?

A
  • Inflated self esteem or grandiosity
  • Decreased need for sleep
  • More talkative than usual or pressure to keep talking
  • Distractibility
  • increase in goal-driven activity or psychomotor agitation
  • Excessive involvement in high risk activities (hypersexual, Excessive spending, gambling)
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10
Q

What must be observed by others in hypomania and mania?

A

The alteration in mood and functioning.

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11
Q

Define Mania

A

A distinct period of abnormally and persistently elevated, expansive or irritable mood.
Persistently and abnormally increased activity or energy lasting at least ONE WEEK, present for most of the day nearly every day.

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12
Q

What is the main difference between mania and hypomania?

A
  • Hypomania lasts around 4 days
  • Mania lasts 7 days at minimum
  • Manic patients have a marked impairment in social or occupational functioning that needs hospitalisation to prevent harm to self or others.
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13
Q

What basic observations and investigations would be appropriate to carry out on an individual presenting with depressive symptoms?

A
  • BP and pulse
  • BMI
  • Bloods; FBC, U&E, LFT, TFT, HbA1c
  • ECG
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14
Q

What are the common side effects of smoking?

A
  • Dry mouth
  • Drowsiness
  • GI upset
  • Mild nausea
  • Low libido, impotence or difficulty having an orgasm
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15
Q

What is the risk of relapse of a major depressive episode (MDE) after 12 months if medications are not continued for a long time?

A

50% relapse rate

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16
Q

List the critical scenarios when GP’s will refer depressed patients to psychiatric services

A
  1. If there is a significant perceived risk of suicide, harm to others or of severe self-neglect
  2. Psychotic syndromes
  3. History of or with clinical suspicion of bipolar disorder
  4. In all cases where a child or adolescence is presenting with major depression
17
Q

When performing a risk assessment on a patient who has had a suicide attempt, what questions would we like to ask (think of 5/12)?

A
  1. What precipitated the attempt?
  2. Why did they choose that time and place?
  3. Was it planned or impulsive?
  4. Did he leave a suicide note?
  5. Were they intoxicated?
  6. Did they take any precautions against discovery (e.g. phoned into work sick the day before, made sure no one was home)
  7. Have they made previous attempts at suicide or self-harm by any methods?
  8. How do they feel about the episode now?
  9. Depression questions
  10. If they go home, what support will they have?
  11. Do they still have suicidal thoughts? Are they a risk to others?
  12. What do they think about the future?
18
Q

Which factors make an individual a higher risk of being successful in their suicide attempt, ending in death?

A
  • Age >45
  • Unemployed
  • Divorced, widowed or single
  • Psychiatric illness
  • Previous suicide attempts
  • FHx of depression, substance misuse or suicide
  • Physical illness
  • Male
  • Substance misuse
19
Q

Define Anhedonia

A

Loss of interest and enjoyment

20
Q

What is a good questionnaire to use when assessing a patients’ mental health/depressive episode?

A

The patient health questionnaire-9 (PHQ-9)

Mental Health (7 decks)

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