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Block 8 Week 6 Rhonda > Schwenk > Depression & Primary Care > Flashcards

Schwenk > Depression & Primary Care Flashcards

1
Q

what impacts physical and social functioning the most?

A

depression

greater than HTN, diabetes, angina, arthritis, GI, lung probs, or low back pain

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2
Q

T/F: you can be depressed without feeling sad

A

true

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3
Q

Depression is an (blank) for poor prognosis

A

independent risk factor

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4
Q

depression causes (poor/better) adherence to meds & tx

A

poor

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5
Q

T/F: depression should be solved alone

A

false

that’s a myth

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6
Q

what are 6 clues to the depressed pt?

A 
verbally unproductive
flat
problem pt
multiple complaints, sx, visits
sx-sign mismatch
physician dysphoria when w/ pt
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7
Q

T/F: pts experiencing depression come to the doctor and complain of depression

A

false

more often it’s chronic pain

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8
Q

who prescribes over half of antidepressants?

A

primary care MDs

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9
Q

more than half of antidepressants are prescribed for what?

A

something other than depression

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10
Q

what are the 6 indications for referral of a mental health pt?

A 
severe suicidal thinking
psychosis, bipolar (axis II)
complicated substance abuse
poor psychosocial support
disorganized rapid deterioration
failed tx
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11
Q

What are the 10 rules for caring for depressed pts?

A
  1. dispel myths
  2. use epidemiology
  3. indirect clues
  4. focus on fxnal impairment
  5. counter competing priorities
  6. co-morbidity
  7. psychopharm
  8. education, supportive counseling
  9. chronic disease tx
  10. psych consult
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12
Q

T/F: depression is a failure of willpower

A

false

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13
Q

T/F: depression can be associated with feelings of inadequacy & guilt

A

true

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14
Q

Depression in primary care is (under/over)appreciated

A

under

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15
Q

depression (increases/decreases) healthcare costs

A

increases

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16
Q

are medical & psych co-morbidities common?

A

yes

and complicating

17
Q

how effective are physician educational interventions?

A

not very

“show little effect”

18
Q

what is the general barrier to improvement in primary care & mental health?

A

systemic problem

not really physician/professional barrier

19
Q

how might a physician cope with depression (poorly)?

A

by working HARDER

20
Q

when do medical student severe depression rates peak?

A

2nd year

21
Q

when did suicidal ideation among medical students peak?

A

4th year (6.6%)

22
Q

do female or male medical students have higher rates of depression?

A

female

15.2% vs 7.9%

23
Q

are depression rates among medical students higher or lower than the age-matched population?

A

higher

24
Q

what 4 groups of medical students had the highest risk of depression?

A

women
unmarried students
students w/ kids
Hispanic students

25
Q

what is the prevalence (%) of XS alcohol use among med students?

A

20%

26
Q

T/F: less students are entering medical school with a hx of depression

A

FALSE

it’s MORE

27
Q

is the suicide risk higher or lower among physicians?

A

higher

  1. 5-3x in men
  2. 5-6x in women
28
Q

what increases the risk of suicide in physicians?

A

disabling physical conditions
professional loss
financial probs
overwork

29
Q

what 4 things are depressed physicians more likely to do?

A

avoid seeking care
self-prescribe antidepressants
seek care outside community or pay cash
don’t seek care at all (d/t concern abt staff privileges or licensing)

30
Q

do depressed or non-depressed medical students say they would seek treatment?

A

non-depressed

31
Q

what are DEPRESSED medical student attitudes about depression?

A

telling someone abt the depression would be risky
admitting depression = inadequate coping skills
makes pt feel less intelligent
means that pt is unable to handle responsibilities
respect opinions less

32
Q

what 5 factors affect medical students w/ depression?

A 
personal weakness
social/professional discrimination
devaluation of depressed students
perceptions of poor performance
need for secrecy
33
Q

what is the “conspiracy of silence”?

A

the fact that stigma reduction in physicians & med students is LAGGING BEHIND stigma reduction in pts

Block 8 Week 6 Rhonda (12 decks)

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