Depression-Shwenk Flashcards Preview

Block 8 Week 6 > Depression-Shwenk > Flashcards

Flashcards in Depression-Shwenk Deck (16):
1

T or F
You can feel sad without being depressed and depressed without feeling sad

T
It is a disease with impaired function of day to day activities

2

Depression is an indepenent risk factor for (blank)

poor prognosis (due to poor adherence, biological impairment, have high levels of morbidity and mortality, reduced function, meds have SEs)

3

T or F
Depression patients have feelings of inadequacy causing guilt

T, though they shouldnt since it is truly a disease

4

Depression involves (single/multiple) organ system

multiple

5

What shoud you ask immediately with a depressed individual?

hows your sleep?
look into emotion and cognition

6

What are co-morbid medical conditions associated with depression?

CHF, DM, HTN, CAD

7

ANy chronic pain diseases or a difficult patient should trigger your mind to think what?

that your patient is depressed

8

What is this:
Verbally unproductive
Flat, “energy sump”
“Problem” patient
Multiple complaints, systems, visits
Symptom-sign mismatch
Physician dysphoria when with patient

depressed patient

9


(blank) of all visits for depression in primary care
(blank)% of visits for antidepressants to primary care
More than (blank) of antidepressants prescribed by primary care physicians
More than half of antidepressants prescribed for reasons other than (blank)

Third
41%
half
depression

10

What are indications for referral?

Severe suicidal thinking
Psychosis, bipolar disorder, Axis II
Complicated substance abuse
Poor psychosocial support
Disorganized, rapid deterioration
Failed treatment

11

Where should you always start with depression?

DISPEL MYTHS

12

What are the 10 rules for caring for depressed patients?

1. Dispel myths
2. Use epidemiology
3. Indirect markers and clues
4. Focus on functional impairment
5. Counter competing priorities (make sure depression is prioritized)
6. Co-morbidity
7. Psychopharmacology
8. Education and supportive counseling
9. Treat as a chronic disease
10. Psychiatric consultation

13

T or F
Physician educational interventions show little effect
Barriers to improvement more systemic than professional

T

14

What medical student are the most depressed?

2nd year female medical students who are unmarried or have children
(medical students are more likely to commit suicide then age matched peers)

15

Why do you think physicians commit suicide more than other occupations?

Avoid seeking care due to privacy concerns/stigma
Prescribe own antidepressant (30% vs. 9.9%)
Seek care outside community and/or pay cash for care
Not seek care due to concern about medical staff privileges or licensing

16

What are the Factors Affecting Medical Students with Depression?

-Med students see depression as personal weakness
-There is social/professional discrimination
-Devaluation of depressed students (think they are not worthy of good school performance)
-Perceptions of poor performance by depressed medical students
-Need for secrecy