1. A Case on Depression Final Year Medical Student Grand Round

2. Background One of the most common reasons for consultation 1 Second most common cause of disability worldwide 2 Female : Male 2:1 3 http://en.wikipedia.prg 4

3. Differential Diagnosis Depression Iron/B12/Folate Deficiency Hypothyroidism Mixed anxiety & Depressive disorder Cyclothymic disorder Substance misuse

4. Classification 5 Symptoms: ↓mood Loss of interest ↓energy ↓concentration ↓self-esteem Guilt/worthlessness Pessimistic thoughts Ideas of self-harm Disturbed sleep Diminished appetite Mild | } any 2 | } any 2 | Moderate | } any 2 | } any 3 | Severe | } all 3 | } ≥ 4 | Miss B | ■ | | ■ | | ■ MODERATE

5. References 1)Shah A. The burden of psychiatric disorder in primary care. Int Rev Psych, 1992; 4:243-250 2)NHS Centre for reviews and dissemination. Improving the recognition and management of depression in primary care. Effective Health Care, 2000; 7. 3)Astbury J, Cabral M. Women’s mental health: an evidence based review. Geneva World Health Organisation, 2000. 4)Clinical Depression. http://en.wikipedia.org/ 5)The ICD-10 Classification of mental and behavioural disorders. Geneva World Health Organisation, 1992.

6. Any questions?