Psychiatry

Question 1

Major Depressive Disorder Symptoms

Answer 1

MSIGECAPS
Mood
Sleep
Interest
Guilt
Energy
Concentration
Appetite/Weight Changes
Psychomotor Disturbance
Suicidal Ideation

Question 2

Major Depressive Disorder Diagnostic Criteria

Answer 2

Greater than or equal to 5 depressive symptoms
(one of which must be mood or interest changes)
-Mood, Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor Disturbances, Suicidal Ideation

Symptoms are present most days for greater than or equal to 2 weeks
Absence of manic/hypomanic episode

Question 3

Screening for Major Depressive Disorder

Answer 3

PHQ-2
(if positive administer PHQ-9)
Beck Depression Inventory for Primary Care

Question 4

Treatment Options for Major Depressive Disorder

Answer 4

SSRIs (first line)
SNRIs
Bupropion
Tricyclic Antisepressants
Monoamine Oxidase Inhibitors
Psychotherapy (also first line)

Question 5

Criteria for Severe Major Depression

Answer 5

Presence of 7-9 depressive symptoms (MSIGECAPS) that occur nearly every day

Question 6

Treatment for Severe Major Depressive Disorder

Answer 6

SNRIs (proven more effective than SSRIs)
SSRIs
Mirtazepine
Electroconvulsive Therapy

Question 7

Persistent Depressive Disorder Criteria

Answer 7

Depressed mood lasting 2+ years
Presence of at least 2 symptoms (ACHESS)
-Appetite Disturbance (dec/inc)
-Concentration/Decision Making Problems
-Hopelessness
-Energy loss
-Sleep Disturbances (hypersomnia/insomnia)
-Self-Esteem
Causes psychosocial impairment/distress
Never asymptomatic > 2 months

Question 8

Treatment for Persistent Depressive Disorder

Answer 8

SSRIs
Bupropion
Psychotherapy (CBT, Interpersonal Therapy)