Mental Health Flashcards
How would you define generalised anxiety disorder?
A feeling of excessive anxiety for most days for a period of 6 months.
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Worries associated with three of the following
- Restlessness/on edge
- Fatigue
- Concentration poor
- Muscle tension
- Sleep disturbance
“Real Feelings Can Manifest Silently”
What is the first line treatment for severe anxiety?
Pharmacological management: SSRI’s - eg. Sertraline, paroxetine, Ecitalopram.
Therapeutic management: high intensity therapy
What is the first line treatment for the management of mild anxiety?
Lifestyle interventions.
- Encourage exercise - at least 30 minutes exercise 5x week
- Improving diet
- Managing any underlying cause of anxiety
What is the first line treatment for mild to moderate anxiety?
Therapeutic intervention. This can be self governed or supervised. This is down to the patients choice.
How would you diagnose generalised anxiety disorder?
Using the DSM-5/GAD7
- Excessive anxiety or worry occurring more days than not for 6 months with difficulty controlling these feelings.
- Additional symptoms: Restless, Fatigue, Concentration poor, Muscle pains, Sleep disturbance
“Real feelings can manifest silently”
What is the mnemonic for assessing someones risk of suicide?
IS PATH WARM
Ideation of suicide - have they thought about it?
Substance abuse
Purposelessness
Anger
Trapped
Hoplessness
Withdrawing
Anxiety
wRecklessness
Mood
If a lot of these questions are answered positively then the patient should be referred onto the crisis team for further management
How would you screen a patient for alcohol misuse?
CAGE questionnaire:
Cut - have you ever felt you should CUT down on your drinking?
Annoyed - have you ever felt ANNOYED by someone criticising your drinking?
Guilty - have you ever felt GUILTY about your drinking
Eye opener - have you ever needed a drink in the morning to feel better or cure a hangover?
If someone presents with both GAD and depression in what order should this be managed?
You should treat the depression first!
How should you interpret a GAD7 grade?
> 5 - mild
> 10 - moderate
> 15 - severe
What health conditions contraindicate the use of SSRI’s?
If the patient is any of the following
- Bipolar
- Manic
- Has a bleeding disorder
- Diabetic
What are the three core symptoms of depression?
During the last month have you been bothered by feeling down, hopeless or depressed?
Do you have little interest or pleasure in doing things?
Lack of energy?
What additional symptoms other than the core symptoms should you ask about in depression?
“Feeling Worthless or Suicidal Can Agitate Appetites Significantly”
Fatigue
Worthlessness
Suicidal thoughts or thoughts of self harm
Concentration is poor
Agitation/psychomotor retardation
Appetite poor
Sleep disturbance - insomnia/hypersomnia
How would you manage patients with depression who did not want any intervention?
You would book a follow up appointment for in 2 weeks time.
How would you manage mild to moderate depression?
Low intensity psychological intervention
Group based CBT
The routine use of antidepressants should be avoided.
When should you consider pharmacological intervention in mild to moderate depression?
When the patient has a history of depression
If their depression is affecting the care of a chronic condition
If they have had depressive symptoms for two years.
