Lecture 14 Primary Care Management of Common Mental health Disorders

Question 1

___in___ people suffer from mental illness

Answer 1

1 in 4

Question 2

What percentage of GP consultations have a mental health component

Answer 2

40%

Question 3

What are the key symptoms of depression

Answer 3

Persistent sadness or low mood
Loss of interest or pleasure
Fatigue or low energy

Question 4

If a patient diagnosed with depression does not respond to treatment what is the next step

Answer 4

Switch to a different SSRI

Switch to another class: TCA, SNRI, MAOI

Question 5

Name a caution for sodium valproate in women

Answer 5

Child bearing age

Question 6

What must be discontinued when patients enter a mani or hypomanic phase

Answer 6

Anti-depressants

Question 7

What is the first line treatment for generalised anxiety disorders

Answer 7

SSRI

Only use Benzodiazepines in acute situations

Question 8

What is the first line treatment for a panic disorder

Answer 8

SSRI

Citalopram, sertraline, paroxetine, escitalopram but NOT fluoxetine

Question 9

What is the first and second line treatment for Social Anxiety Disorder

Answer 9

CBT

Sertraline or Escitalopram

Question 10

What is the first and second line treatment of OCD

Answer 10

CBT

SSRIs sertraline/citalopram/fluoxetine/paroxetine

Question 11

What is the management of insomnia

Answer 11

Sleep hygiene
Remove precipitants
CBT
Melatonin

Question 12

What are the side effects of Lithium (Toxicity)

Answer 12

Fine tremor
Dry mouth
Altered taste sensation
Increased thirst
Urinary frequent
Mild nausea
Weight gain