NICE Guidelines Of Depression

Question 1

What is CGASPDIE?

Answer 1

Concentration difficulties
Guilt or feeling worthless
Appetite or weight changes
Sleep disturbance
Psychomotor retardation/agitation
Death or suicide (ideas of)
Interest (diminished)
Energy (loss)

Question 2

Explain the NICE guidelines re SSRI choice

Answer 2

Generic form
Citalopram and fluoxetine
Sertraline safest in cardiovascular disease

Question 3

Describe the stepped care model

Answer 3

Step 1 - recognition in primary care and general hospital settings –> watchful waiting
Step 2 - treatment of mild depression in primary care –> watchful waiting, guided self help, computerised CBT, exercise, brief psychological interventions
Step 3 - treatment of moderate to severe depression in primary care –> medication, psychological interventions, social support
Step 4 - treatment of depression by mental health specialists (treatment resistant, recurrent, atypical, psychotic, significant risk) –> medication, complex psychological interventions, combined treatments
Step 5 - inpatient treatment for depression (risk to life, severe self neglect) –> medications, combined treatments, ECT