Depression

Question 1

What are the 2 core symptoms of depression?

Answer 1

Persistent sadness/ low mood ~ every day.

Loss of interest/ pleasure in most activities.

Question 2

What 8 symptoms may accompany the core symptoms of depression?

Answer 2

Fatigue
Worthlessness, excessive/ inappropriate guilt.
Recurrent thoughts of death/ suicidal thoughts
Difficulty concentrating
Psychomotor disturbance
Insomnia/ hypersomnia.
Changes in appetite
Weight change

Question 3

How long should symptoms have persisted for to be considered depression?

Answer 3

> ,2 weeks

Question 4

List 5 risk factors for depression

Answer 4

FEMALE
PMH of depression
Significant physical illness causing disability or pain
Other MH problems (e.g. dementia)
Psychosocial problems (eg, divorce, unemployment)

Question 5

What may cause a missed diagnosis of depression?

Answer 5

Somatisation

physical symptoms resulting from psychiatric illness

Question 6

List 3 assessment tools for depression

Answer 6

Patient Health Questionnaire (PHQ-9)
Hospital Anxiety + Depression (HAD) Scale
Beck’s Depression Inventory

Question 7

What differentials must you exclude before diagnosing depression?

Answer 7

Organic causes:
hypothyroidism
hypercalcaemia
Addison's disease
Cushing's disease
Folate deficiency
Anaemia
Neurological disturbance

Question 8

What drugs may be causing depressive symptoms?

Answer 8

B-blockers
Digoxin
Anti-epileptics

Question 9

What differential could cause depressive episodes?

Answer 9

Bipolar disorder

Question 10

What investigations should you perform to exclude other causes of depression?

Answer 10

FBC  
Blood glucose  
U+Es 
TFTs 
Calcium  
MRI/CT