Summary
Quick Summary of Depression and Insomnia - GP Management
- Module
- Institution
Structured summary of depression and insomnia investigations and management in a GP setting - structured for OSCES
[Show more]
Seller
Follow
celestelee
Content preview
DEPRESSION● Investigations: FBC, TSH, B12, rapid plasma reagin (RPR), HIV, electrolytes, BUN,
UEC, FLTs, BAC, ABG, dexamethasone suppression test (cushing disease also
positive in depression), neuroimaging, ACTH stimulation test
● Types: major depressive disorder, with anxiety, with melancholic features, with
catatonia, atypical, postpartum, seasonal affective disorder, with psychotic features,
metabolic
● Assessment: what sort of depression, eliminate/identify suicidality, identify major
illness, identify environmental influences
● Screening: DASS, K10
● Severity differentiation:
○ depressed mood most reliable to discriminate moderate from non-depression
○ Somatic factors useful for differentiating moderate from nondepression
○ Non-somatic DSM-5 criteria distinguish moderate from severe
○ Severe from moderate most reliable symptom is suicidality →
anhedonia, worthlessness, depressed mood
● Overall Mx:
1. Comprehensive assessmentss
2. Ongoing safety evaluations
3. Setting treatment goals
4. Agreed upon treatment plan to meet goal
5. Good support network
6. Mood charting
7. Systematic, meaningful appointments: review suicidality, triggers, adherence,
side effects, general health measures, substance, progress towards goal
○ Refer to psychologist, psychiatrist for complex issues requiring additional
treatment/complex medication
○ Refer to physio/massage
● Mx:
○ 1st line: lifestyle - avoid alcohol, exercise, stress reduction, diet, sleep, social
support, hobbies, nature
○ 2nd line: psychological (mild depression) - counselling with clinical
psychologist (mental health treatment plan 20 sessions), online (thiswayup,
moodgym, CBT courses), mindfulness medication (smiling minds)
○ 3rd line: medications - moderate-severe depression
■ 1st line: any SSRI or escitalopram, agomelatine
■ 2nd line: another SSRI or SNRI or mirtazapine, venlafaxine
■ Start low-mod dose of 1st line - ½ dose for 1st 3 days
■ Review at 3-4 weeks - good response → continue; partial
response → increase dose until max dose/SE; no response →
alternative from either same/different class
■ After try 2 drugs + no response refer to psychiatrist who will
→
■ Add 2nd agent: 2nd antidepressant, 2nd generation antipsychotic
(olanzapine, risperidone), lithium
● Don’t mix MAOIs with other antidepressants
● Don’t give paroxetine to young women who want to carry child
● Don’t combine bupropion and venlafaxine
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller celestelee. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for £2.44. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75632 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy revision notes and other study material for 14 years now