Steps of Clinical Assessment   Step 1: Listen to the patient carefully, establish rapport, and develop a therapeutic alliance. Step 2: Confirm the diagnosis by identifying the full spectrum of signs and symptoms of depression and anxiety, and confirm a lack of a history of mania . Also exclude organicity especially hyper/hypothyroidism, Cushing disease, brain tumors, and any other physical conditions that can induce or mimic the symptoms of depression. A detailed medical history, physical examination, and relevant laboratory investigations (TFTs,   Cortisol, DST, brain imaging, ECG, etc.) Should be obtained for this purpose. Exclude (depression/anxiety as) the impact of medications (e.g. propranolol), substances of abuse, and alcohol.   Step 3: Assess the severity clinically and to monitor, with a standard scale, (HAMD/HAM-A, BDI/BAI, etc). Severity also influences the choice of treatment. Step 4: Assess the impact of the condition on the patient and family, including p...

Classification of Depression According to the International Classification Diseases, Tenth Revision (ICD-10) Waleed Ahmad The ICD-10 has comprehensively sub-classified into various categories based on the clinical profile of symptoms and the course of symptoms.  Based on the course, it may be a depressive episode, recurrent (major) depressive disorder, persistent depressive disorder or dysthymia, recurrent brief depression, etc. Depression may also be either unipolar or bipolar or it may occur in   A first depressive episode, duration of at least15 days, is classified as a  depressive episode (F32).  If the first depressive episode severe and rapid onset, duration less than 15 days still depressive episode (F32).   A depressive episode can be mild (2 core symptoms, 2 other symptoms from the list) (32.0) moderate (2 core symptoms, 3 or preferably 4 other symptoms) (32.1) Severe (3 core symptoms, 4 other symptoms) without psychotic symptoms (32.2) (no d...

Impaired alertness is generally a feature of delirium. In one form of dementia, however, 'fluctuating alertness' is a striking feature. Can you name it? Lewy body dementia

The Safest NSAID for a patient on lithium What is the most suitable non-steroidal anti-inflammatory drug (NSAID) you can prescribe to a patient who is on Lithium therapy? >> Aspirin or Sulindac. 

Can you answer any one or two of these right? 1. In visual perception, the recurrence or prolongation of a visual phenomenon beyond the customary limits of the appearance of the real event in the world is termed ___________ 2. The size of the perception can be either larger '________' or smaller ' ___________' than expected. 3. In some cases, there can be apparent reduction in one hemifield of vision '_____________' 4. These anomalies are common in ______________. 5. Alteration in the customary shape of the perceived object is termed __________ . 6. ‘One woman saw people upside down, on their heads’ (Bleuler, 1950). This is an example of ___________ 7. When metamorphopsia affects faces, it is referred to as __________. 8. , ____________, is the complete absence of colour 9. ______________ refers to the perversion of colour perception 10. . ___________ involves the object appearing far away, 11. __________ is the term used when the object is appearing nearer t...