Depression & Anxiety Flashcards
What are the key symptoms of depression?
Anhedonia Early morning wakening and difficulty sleeping Low mood Loss of appetite/weight loss Lack of energy/concentration Thoughts of worthlessness Thoughts of self harm/suicide Guilt
What sections are in the mental state exam?
Appearance - Well maintained? Behaviour - Eye contact? Anger, fidgeting Speech -Slow Vs Pressured speech, language used Mood - Low Vs High, Flat, Anger, Anxious Thoughts - Harm to self or others Hallucinations Delusions Insight into life/world Cognition - Dementia screen Risk assessment
What is the management of depression?
Increase exercise
CBT
SSRIs - Sertraline (50mg OD - Good for depression & anxiety mix), Citalopram (20mg OD)
What are the depression screening questions for patients with chronic diseases?
In the last month have you felt;
Low, depressed or hopeless
Little interest in doing things
What tools can be used to score depression?
PHQ9
HAD score
What is generalised anxiety disorder?
Psychological symptoms - Fearful anticipation, irritability, restlessness, poor concentration
Physical symptoms - Palpitations, dry mouth, tremor. dizziness, nausea
What is the management of generalised anxiety disorder?
Check TFTs for Hyperthyroidism
Avoid triggers
CBT
SSRI - Sertraline 50mg OD
What is panic disorder?
Panic attacks - feeling of smothering, SOB, choking sensation,, palpitations, tachycardia
Fear of dying, doing something crazy or being uncontrolled
What are some of the specific triggers for panic disorder?
Generalised anxiety disorder
Depression
What is the management of panic disorder?
CBT
SSRI - Paroxetine, Citalopram (20mg OD)
What screening tool can be used to assess a patient’s drinking habit?
C - Have you ever thought about cutting down?
A - Have you ever got into an argument with someone for criticising your drinking habits?
G - Do you ever feel guilty about drinking?
E - Do you ever have an ‘eye opener’ in the morning?
