Mental Health

Question 1

Anxiety/ Depression Mx

Answer 1

1st - low intensity psych intervention
- self help, psychoeducational groups

2nd - high intensity psych intervention
CBT and/ or medication
SSRI - GI upset, takes 4-6 weeks to work, can feel worse initially
Propranolol (not asthmatics) - help physical symptoms
alternatives - SNRI (Venlafaxine/ duloxetine), pregabalin

3rd - refer (after 2 attempts of full dose medications tried)

Question 2

Postnatal depression/ psychosis stages

Answer 2

Baby Blues - very common (>50%)
low mood, anxiety, irritable, tearful
3-4 days post natal, resolve by day 10 - be suspicious if symptoms longer than 2 weeks

Post natal depression - <15% women
First 8 weeks to several months
- check risk to mum and baby
- low risk = health visitor, community mental health team, supportive family
- high risk = perinatal psych team, admission

Postpartum psychosis <0.1%
- within first 2 weeks
- admission within 4 hours

Question 3

Depression screening questions (2)

Answer 3

‘During the past month, have you often been bothered by feeling down, depressed or hopeless?

During the past month,
have you often been bothered by having little interest or pleasure in doing things?’

Question 4

Eating disorder Hx

Answer 4

Rapid weight loss
Atypical dental wear (e.g. erosion)
Weight concerns and not overweight
GI symptoms
Menstrual disturbances

Question 5

Eating disorder Mx

Answer 5

Refer to eating disorder psych team

Admission if suspicion of electrolyte abnormality, malnutrition, dehydration, organ failure