Flashcards in Depression-Shwenk Deck (16):
T or F
You can feel sad without being depressed and depressed without feeling sad
It is a disease with impaired function of day to day activities
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)
T or F
Depression patients have feelings of inadequacy causing guilt
T, though they shouldnt since it is truly a disease
Depression involves (single/multiple) organ system
What shoud you ask immediately with a depressed individual?
hows your sleep?
look into emotion and cognition
What are co-morbid medical conditions associated with depression?
CHF, DM, HTN, CAD
ANy chronic pain diseases or a difficult patient should trigger your mind to think what?
that your patient is depressed
What is this:
Flat, “energy sump”
Multiple complaints, systems, visits
Physician dysphoria when with patient
(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)
What are indications for referral?
Severe suicidal thinking
Psychosis, bipolar disorder, Axis II
Complicated substance abuse
Poor psychosocial support
Disorganized, rapid deterioration
Where should you always start with depression?
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)
8. Education and supportive counseling
9. Treat as a chronic disease
10. Psychiatric consultation
T or F
Physician educational interventions show little effect
Barriers to improvement more systemic than professional
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)
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