Treating affective disorders

Question 1

How is mental health often describe in primary care?

Answer 1

Physical issues

Question 2

What are the 4 key factors in primary career?

Answer 2

Communication

Shared decision making

Pragmatic

Focused

Question 3

What did Kendricks study regarding antidepressant prescription report?

Answer 3

That £280 mill is sent on them

11% of patients are prescribed them

50 million prescriptions a year

Not useful on Mild Depression, so NICE guidelines introduced 2004

Question 4

Who might the Mediterranean diet be useful for and why?

Answer 4

Depressed patients with type 2 diabetes

It reduces inflammation

Question 5

What is the evidence regarding fish and gluten and mental health?

Answer 5

Countries with high fish consumption have lower rates of depression

Bi polar and Schizophrenics can have antibodies to gluten.

Coeliac patients improve anxiety and depression by cutting it out

Question 6

What is FODMAP

Answer 6

Short Chain, poorly digestible carbs that leads to bloating and IBS.

Not the same as Gluten, often confused

Question 7

What did the Salerno expert found regarding non-coeliac gluten sensitivity?

Answer 7

That there are way to many symptoms and there needs to be a test to confirm who is NCGS.

Question 8

What are the common questionnaires used to assess depression?

Answer 8

PHQ-2 and PHQ-9

Both over 2 weeks

PH-9- 5 mild, 10, moderate, 15 severe and 20 very severe. Made by Pfizer

90% sensitivity

Question 9

What is the difference between the types of Bi-polars?

Answer 9

BP1: 7 days or more of mania without depression (clearest diagnosis)

BP2: Recurrent major depression and Hypomania more than once and for less than 4 days

BP spectrum disorder

Question 10

What 5 factors may indicate a Bipolar patient?

Answer 10

Atypical depression

Borderline PD

Family history

Non-response to 2 antidepressants

Antidepressants cause hypomania

Question 11

What it the role of the NHS improving Access to Psychological Therapies?

Answer 11

To increase the number of therapists so GP’s don’t just prescribe anti-depressants.

900 000 treated a year.

Question 12

What are the guidelines for administering antidepressants?

Answer 12

Mainly for servere and moderate depression, However chronic subthresshold or subdyronal too.

SSRI’s preferred, 50% efficacy

Tricyclics can be used for depression form chronic pain