Depression Flashcards
(51 cards)
frequency of the short course of CBT offered
6-8 sessions over 10-12 weeks, 1-1 with a counsellor trained in CBT
Aim of CBT
concentrates on how to change the way you think, feel and behave in the present
teaches you how to overcome negative thoughts, and challenge hopeless feelings
5 types of non medical treatments for depression
- CBT
- online CBT
- IPT (interpersonal therapy)
- psychodynamic psychotherapy
- counselling
purpose of risk assessment?
helps the doctor how to decide to proceed in managing a patient with thoughts of suicide/following an act of self harm
4 presentations in which require ASAP referral to psychiatric services
- Significant perceived risk of suicide, harm to others or severe self-neglect
- Presence of psychotic symptoms
- If there is a history or clinical suspicion of bipolar disorder
- In all cases where a child or adolescent is presenting with major depression
risk factors associated with a higher risk of suicide
- age > 45 y/o
- unemployed
- male
- divorced/widowed/single
- substance misuse
- fh of depression/suicide
- psychiatric illness
- physical illness
minimum period over which antidepressants should be tapered down over when stopping antidepressants?
purpose of this?
- 4 weeks
- risk of withdrawal syndrome
common symptoms of withdrawal syndrome?
- dizziness
- headache
- nausea
- lethargy
2 depression questionairres
- PHQ-9
- HADS
recommended threshold for PHQ-9 score for considering intervention
12
questionairre to assess severity of depression and response to treatment, mainly in primary care
PHQ-19
medical conditions that may cause depressive symptoms
- chronic health conditions
- hypothyroidism
- addisons disease
- diabetes mellitus
- alcohol/substance abuse
medications that may cause depressive symptoms
- corticosteroids
- beta blockers
- statins
- OCP
- isotretinoin
formula to calculate units of alcohol
mls x %ABV
/
1000
investigations in a patient presenting with depressive symotoms
- BP, pulse
- Bloods
- ECG
- BMI
medications that increase QT interval + risk of ventricular arrhythmias
- Citalopram
- Escitalopram
- Amitrypytline
risk factors for relapse of depressive episode (3)
- severity of previous episode
- number of relapses
- presence of residual symptoms
continue antidepressant treatment for how long following a major depressive episode for:
Low risk of relapse
low risk = 1 only episode previously without other risk factors
6-9 months after full remission
what defines a patient at high risk of relapse of a depressive episode
> 5 lifetime episodes
OR
2 episodes in last few years
length of antidepressant treatment following a depressive episode in a patient at high risk of relapse
2 years at least, longer term treatment should be considered
team that assesses patients following attempted suicide
Mental health crisis team
+ urgent assessment under mental health act
CRHTT
Crisis Resolution Home Treatment Team
2 screening questions for depression?
During the last month have you ever felt down or hopeless
During the last month have you often become bothered by having little interest or pleasure in doing things
cognitive features of depression (3)
- poor concentration
- poor self esteem
- ideas of guilt + unworthiness
