Accessible CBL Template
STUDENT CBL Sheet
CBL No. 2 - Depression│Mental Health│Year 4
Year: 4
Date: 2019/20
Placement: Mental Health
Learning outcomes
1. To be aware of the epidemiology of and aetiological factors and risk factors for depression
2. To describe the symptoms and presenting features of depression
3. To able to screen for depression and identify high risk individuals
4. To be aware of the diagnostic classification of depression
5. To describe the management of mild, moderate and severe depression and be able to formulate a management plan (short-, medium- and long-term)
6. To know the main classes of antidepressant medications and their side effects
Case 1
History
A 40 year old woman who works as a pharmacist presents with depressed mood throughout the day for two months. She has stopped going out with friends and family, has not been showing interest in eating. She wakes up at 3 a.m worrying about everything. She feels drained all the time and is unable to get any enjoyment from her hobbies. She feels worthless and does not feel that life is worth living anymore. She has recurrent thoughts of hanging herself to “finish it all.” She appears vacant and can’t engage in much conversation. She has had two such episodes in the past and had good recovery with ECT on both occasions.
Questions from tutor
Q1. What are the symptoms of depression that the patient exhibits?
Q2: What is the most likely diagnosis?
Q3: What are the indications of ECT?
Q4: What are the risk factors for suicide in this case?
Case 2
History
A 50 year old woman is brought to hospital after attempting to commit suicide by overdose of an unknown number of Paracetamol tablets. She is now medically fit to be discharged after medical treatment of the overdose. You are informed that she has been taking Amitryptiline for a few years. During the assessment with you, she sits slumped in the chair and makes no eye contact. She hardly makes any movement, does not speak at all other than saying that she “deserves to die for her sins.” She has been married for 30 years. Her husband informs you her depression has worsened in the last month and she has been constantly feeling guilty about minor things and believes she deserves severe punishment or death for it. She refuses informal admission because she believes she does not deserve anything.
Questions for discussion:
Q1: Identify all the psychopathology in the case.
Q2: What is the most likely diagnosis? What is the ICD-10 code for her diagnosis?
Q3: What is the mechanism of action of SSRI, SNRI and tricyclic antidepressants?
Q4: How would you ensure she receives the treatment she requires?
Contact your Year Lead if you find any digital content difficult or impossible to use, either directly or with an assistive technology such as a screen reader.
Contact details for all teams and individual staff can be found on the School website. [liverpool.ac.uk/medicine/contact-us/email/].
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