ILA 5 - Depression

Question 1

History taking model for psych behaviours

Answer 1

Biopsychosocial assessment. Identify factors which has led to mood or behaviour in life. Holistic approach.

Question 2

Mental State examination components

Answer 2

Appearance & behaviour
Speech
Mood
Perceptions
Thoughts
Cognition
Insight

Question 3

3 main symptoms of depression

Answer 3

anergia, anhedonia, low mood.

Question 4

Suicide risk assessment

Answer 4

Felt life is not worth living?
Thoughts of taking your life and plans/ever tried?
Intended to hurt yourself?
Do they have the means to carry out action (have gun at home)?

Question 5

Low mood differentials

Answer 5

Unipolar depression/Major depressive disorder/Recurrent depressive disorder.
Dysthymia (mild depression)
Grief reaction
Bipolar affective disorder
Cyclothymia (mild low mood and mania)
Schizophrenia disorder
Dementia
Alcohol
Hypothyroidism
Vit D deficiency
Menopausal
Post-natal/adjustment/seasonal affective

Question 6

Grief V major depressive disorder

Answer 6

Grief = insight into trigger of low mood, able to look forwards to future, capacity to experience pleasure, fluctuating

Question 7

Diagnosis and tools and investigations of depression

Answer 7

1 core symptom and 4 others. PHQ-9 questionnaire. TSH, LFT (gamma GT), LH:FSH, FBC, U&E

Question 8

Risk factors for suicide

Answer 8

MALE, under 30, recently started on antiDx, substance misuse, living alone, prior attempt.

Question 9

Risk factors for depression

Answer 9

Low Socio-economic status, unemployed, unmarried/divorced, LGBTQ+, recent adverse effect, physical or chronic illness, alcohol, social isolation.

Question 10

Section 2 mental health act

Answer 10

admission for assessment for 28 days. Treatment may be given without consent, Issued by Approved Mental Health Professional and 2 doctors.

Question 11

Section 3 mental health act

Answer 11

Admission for treatment, lasting 6 months (renewed once 6months and third time for a year). Must have viable treatment plan. Issued by Approved Mental Health Professional and 2 doctors.

Question 12

Section 4 mental health act

Answer 12

emergency urgent detention for 72hrs for assessment. Requires 1 doctor.

Question 13

Section 5 [2]

Answer 13

doctors holding power for assessment. lasting 72hrs, NOT PUBLIC PLACE (A&E). Section 5 [4] is nurse’s holding power lasting 6hrs.

Question 14

Section 135

Answer 14

entry to private property with police for 72hrs from Magistrates.

Question 15

Section 136

Answer 15

Section 136 allows to detain someone in a public place by police.

Question 16

Treatment for mild-moderate depression

Answer 16

Sign post to resources for stress management info, mindfulness, online CBT (mood juice). Active patient monitoring. Low intensity psychotherapy via IAPT. Consider drugs if persistent (>2yrs)

Question 17

Treatment for moderate-severe depression

Answer 17

High intensity psychotherapy or antidepressant drug (SSRI)

Question 18

Treatment for severe depression

Answer 18

High intensity psychotherapy + antidepressant drug (SSRI)

Question 19

Lifestyle advice for depression

Answer 19

sleep hygiene, physical exercise, alcohol intake, recreational drug use.