Psychiatry

Question 1

3 types of mood disorders

Answer 1

Depressive - single/recurrent
Bipolar - Mania, hypomania, mixed
Persistent mood - Cyclothymia, dysthymia

Question 2

Core symptoms of depression

Answer 2

Continuous low mood for at least 2 weeks
Lack of energy
Lack of enjoyment/interest (anhedonia)

Question 3

Somatic depression symptoms

Answer 3

Low self-esteem
Guilt/self-blame
Hopelessness
Hypochondriacal thoughts
Poor concentration/attention
Suicidal thoughts

Question 4

Mild depression

Answer 4

2 core symptoms + 2 other (able to function)

Question 5

Moderate depression

Answer 5

2 core symptoms + 3 (/4) others

Question 6

Severe depression

Answer 6

3 core symptoms + at least 4 others

Question 7

Severe depression with psychotic symptoms

Answer 7

Severe criteria + auditory hallucinations and delusional thinking (hypochondriacal/guilt/nihilistic/persecutory)

Question 8

Differentials for depression

Answer 8

Schizophrenia, bipolar, anorexia nervosa, anxiety, substance misuse, dementia, sleep disorders, physical illness

Question 9

Mild depression management

Answer 9

Sleep hygiene, anxiety management (mindfulness, problem solving)
Guided self-help books
Group based programmes
→Anti-depressants only after 8 weeks

Question 10

Moderate depression management

Answer 10

Combination of SSRI and high intensity psychological intervention (CBT/IPT)

Question 11

Severe depression management

Answer 11

Specialist assessment with consideration to admit (section if necessary)
ECT

Question 12

Diagnostic tool for depression

Answer 12

PHQ-9
5-9 – Minimal symptoms
10-14 – Minor depression
15-19 – Major depression
>20 – Major depression

Question 13

Electro-convulsion therapy