Psych: Depression: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Depression (Major Depressive Disorder)🎧 A clear, high-yield breakdown of this common mood disorder with persistent low mood and anhedonia – perfect for exam prep and real-life clinical scenarios.🧠 Key Learning Points📌 Definition• A common and serious mood disorder marked by persistent sadness or loss of interest/pleasure (anhedonia) lasting ≥2 weeks, with significant impact on daily life and functioning.• Diagnosed via ICD-11 or DSM-5 criteria.📌 Causes & Risk Factors• Multifactorial: genetic, biological, psychological, and environmental factors• Family history of depression• Hormonal changes (e.g. adolescence, postpartum)• Chronic medical illness• Stressful life events• Substance misuse• Female sex💡 Mnemonic: “SAD CHIMPS” – Stress, Alcohol, Drugs, Chronic illness, Hormones, Inheritance, Mood, Personality, Support lacking📌 Pathophysiology• Dysfunction of neurotransmitters: serotonin, dopamine, noradrenaline• Hypoactivity in prefrontal cortex and limbic system• Structural/functional brain changes in imaging studies📌 Symptoms• Low mood, anhedonia, fatigue• Appetite/sleep changes (↑ or ↓)• Poor concentration and memory (“brain fog”)• Feelings of guilt, worthlessness• Suicidal ideation or thoughts of death• Psychomotor changes• Physical symptoms (e.g. headaches, GI issues)💡 Mnemonic: “SIGECAPS” – Sleep, Interest ↓, Guilt, Energy ↓, Concentration ↓, Appetite ↑/↓, Psychomotor, Suicide thoughts📌 Differential Diagnosis• Bipolar disorder (rule out mania/hypomania)• Dysthymia (chronic, mild low mood)• Adjustment disorder• Anxiety disorders• Hypothyroidism, anaemia, chronic fatigue syndrome• Substance-induced mood disorder• Borderline personality disorder, schizophrenia📌 Diagnosis• Clinical diagnosis based on psychiatric history + mental state exam• Use PHQ-9, HADS, Beck Depression Inventory• Assess for suicidality, psychosis, and functional impairment• Physical exam + labs to exclude organic causes:– TFTs, FBC, B12/folate, cortisol, LFTs, U&Es, glucose, calcium• Imaging (MRI/CT) only if atypical presentation or neuro features📌 Management🔹 Psychological therapies• CBT, interpersonal therapy (IPT), guided self-help🔹 Pharmacological treatment• SSRIs first-line• Second-line: alternative SSRI• Third-line: mirtazapine, venlafaxine🔹 Lifestyle interventions• Sleep hygiene, regular exercise, stress management🔹 Severe/refractory cases• Specialist referral• Hospitalisation if suicide risk• ECT, RTMS, VNS as advanced options🔹 Collaborative care• Especially useful in elderly, comorbid medical illness, or social isolation📌 Complications• Suicide/self-harm• Occupational and social impairment• Relationship/family breakdown• Substance misuse• Development of other psychiatric disorders• Worsening of comorbid physical illnesses• Antidepressant-related: discontinuation syndrome, activation of mania📌 Prognosis• 50% recover in 6 months, 75% in 1 year• Recurrence in 80%, with median of 4 episodes• Untreated sub-threshold depression → 70% risk of full MDD• Poorer outcomes in older age, comorbid anxiety, psychosis, personality disorder• Persistent depression in 10%, chronic in 27%📎 More MSRA Resources for Depression📝 Revision Notes: https://www.passthemsra.com/topic/depression-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/depression-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/depression-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/depression-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/psychiatry-for-the-msra/Hashtags#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQ&ANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #Depression #Psychiatry #MajorDepressiveDisorder