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Medicine Year 2 > Low Mood - Effective consulting > Flashcards

Low Mood - Effective consulting Flashcards

1
Q

How do patients with depression present to doctors?

A
  • feeling low
  • lost interest
  • tired all the time (somatic syndromes)
  • stomach pain/ headaches
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2
Q

What can depression lead to?

A
  • weight loss
  • lack of self care
  • not taking medication
  • unexplained symptoms
  • disturbed sleep
  • fatigue
  • poor concentration
  • suicidal thoughts
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3
Q

What are core symptoms?

A

(one must be present >2 weeks affecting patients life for a diagnosis of depression)
eg, persistent low mood, loss of interest/ pleasure

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4
Q

What areas of sleep might be affected?

A
  • initial or middle insomnia
  • early morning waking
  • over sleeping
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5
Q

What family history might lead to mental illnesses?

A
  • schizophrenia
  • bipolar disorder
  • major depression
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6
Q

What is the spectrum of risk to self?

A
  • self harm can be physical self abuse to engaging in risky behaviour
  • self harm and suicidal thinking can be a coping mechanism
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7
Q

What are some red flags for suicidial thoughts?

A
  • clear and detailed plan
  • social isolation
  • hopelessness
  • chronic illness
  • background risk factors
  • severity of psychiatric state
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8
Q

How to examine a patient with potential mental health issues?

A
  • appearance
  • behaviour
  • speech
  • mood and affect
  • thought
  • perception
  • cognition
  • insight and judgement
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9
Q

What is the human condition?

A
  • stress, anxiety, worry, guilt, remorse
  • fluctuations in mood
  • fluctuations in energy, motivation and sleep
  • normal response to distressing external events eg. loss, illness, traumatic events
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10
Q

What is grief?

A
  • distressing normal reaction to intense emotional pain
  • numbness, unreality, yearning, anger
  • impact on appetite and sleep
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11
Q

How to diagnose depression?

A
  • not attributable to other causes

- causing significant distress or functional impairment

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12
Q

What is severe depression?

A

has most of the 9 symptoms including one of the core symptoms
-symptoms interfere with functioning

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13
Q

What is depressive symptoms?

A

lasting 2 years or more

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14
Q

What is the subthreshold for depression?

A

at least 2, less than 5 symptoms

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15
Q

What is used to assess the severity of depression?

A

PHQ-9 questionnaire

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16
Q

What is atypical depression?

A

present with reactive mood, weight gain, increased appetite and excessive sleepiness

17
Q

Why is depression still underdiagnosed? (patient factors)

A
  • stigma/ embarrassment/ shame
  • fear
  • doesn’t fit with socio cultural perspective
  • thinking no one can help
18
Q

Why is depression underdiagnosed? (doctor factors)

A
  • more pressing problems

- missed (lack of recognition, hidden or time pressure)

19
Q

What are some specific risks for depression?

A
  • social problems eg. unemployment
  • psychiatric problems eg. substance misuse
  • physical disorders eg. diabetes, CHD
  • drugs that cause symptoms of depression eg. beta blockers
20
Q

What are the options to treat depression?

A
  • lifestyle
  • therapy
  • pharmacological
21
Q

What lifestyle changes can be done?

A
  • establish routines
  • eat well
  • exercise
  • re-engage
  • sleep hygiene
  • avoid alcohol and mood depressants
22
Q

What are some supportive interventions?

A
  • therapeutic conversations/ brief interventions
  • self help programmes eg. books
  • counselling
23
Q

What are some therapy interventions?

A
  • CBT/ psychological interventions

- therapeutic services eg. RELATE, CRUSE, trauma focused, sexual assault

24
Q

What is CBT?

A

Cognitive behavioural therapy

25
Q

What medications might be used for treatment?

A

selective serotonin reuptake inhibitors (SSRIs)

26
Q

What should patients be advised about with SSRIs?

A
  • takes time to work
  • common side effects eg. GI upset, headaches, anxiety
  • serious side effects eg. vivid dreams, suicidal ideation
  • take for 4-6 months after feeling better
27
Q

What is anxiety a main symptom of?

A
  • panic disorder
  • social anxiety
  • PTSD
  • phobias
  • generalised anxiety disorder

Medicine Year 2 (9 decks)

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