Mental Health in Primary Care

Question 1

What screening tool is used for depression?

Answer 1

PHQ-9

Question 2

How is the PHQ-9 used to score severity of depression?

Answer 2

Based on DSM-IV

• 0-5 mild depression
• 6-10 moderate
• 11-15 moderately severe
• 16-20 severe depression

Question 3

Step 1 for treatment of depression

Answer 3

Least intrusive, recognition, assessment and initial management

Question 4

Step 2 for treatment of depression

Answer 4

Low-intensity psychological and psychosocial interventions. Offer advice on sleep hygiene, offer active monitoring.

Question 5

Step 3 for treatment of depression

Answer 5

High-intensity psychological intervention. Offer antidepressants (SSRI)

Question 6

If unresponsive to Step 3 for treatment of depression?

Answer 6

Switch to a different SSRI or another class eg TCA, venlafaxine or MAOI

Question 7

What does Step 4 depression look like?

Answer 7

Severe and complex depression with a risk to life and severe self-neglect

Question 8

Step 1 for treatment of anxiety

Answer 8

Identification and assessment and offer education and active monitoring

Question 9

Step 2 for treatment of anxiety

Answer 9

Low intensity psychological interventions

Question 10

Step 3 for treatment of anxiety

Answer 10

High intensity psychological intervention or drug therapy eg SSRI

Question 11

What does Step 4 anxiety look like?

Answer 11

Severe functional impairment and combined drug and psychological interventions