`çããçå=jéåí~ä= aáëçêçéêëw=^åñáéíó=~åç= aééêéëëáçå. aêk=`=f=lâçåü~ jéçáå~ä=aáêéåíçê lñäé~ë=kep=cçìåç~íáçå=qêìëí=

Size: px
Start display at page:

Download "`çããçå=jéåí~ä= aáëçêçéêëw=^åñáéíó=~åç= aééêéëëáçå. aêk=`=f=lâçåü~ jéçáå~ä=aáêéåíçê lñäé~ë=kep=cçìåç~íáçå=qêìëí="

Transcription

1 `çããçå=jéåí~ä= aáëçêçéêëw=^åñáéíó=~åç= aééêéëëáçå aêk=`=f=lâçåü~ jéçáå~ä=aáêéåíçê lñäé~ë=kep=cçìåç~íáçå=qêìëí=

2 Overview: Common Mental What are they? Disorders Why are they important? How do they affect sufferers? What should you look out for? What are the risks? When should you refer to secondary care?

3 Common Mental Disorders Depression Anxiety Disorders Generalized Anxiety Disorder Panic Disorder Phobic Anxiety Disorder Social Anxiety Disorder Obsessive Compulsive Disorder Post Traumatic Stress Disorder

4 Common Mental Disorders: and these too! Mixed Anxiety and Depression Adjustment Disorders Mixed anxiety & depressive reaction Brief or prolonged depressive reaction Disturbance of emotions, conduct or both Dysthymia sub threshold depression Remember they occur with other disorders e.g., PD

5 Proportion of people aged meeting the criteria for at least one common mental disorder in England NVVP========================OMMM========================OMMT pçìêåéw=eçìëéüçäç=ëìêîéó=çñ=éëóåüá~íêáå=ãçêäáçáíó=áå=båöä~åçi=ommt=e=çåé= ïééâ=éêéî~äéååéf=kep=fåñçêã~íáçå=`éåíêéi=ommu

6 How common are they? One week and lifetime prevalence rates Common Mental Disorder Mixed Anxiety & Depression Generalized Anxiety Disorder 1-week prevalence (England 2007) 9% - 4.4% 5.7% PTSD 3% 6.8% Depression 2.3% 16.6% Phobias 1.4% 12.5% Panic Disorder 1.1% 4.7% Life-time prevalence (USA 2005)

7 Why are they important? On the increase 1:6 people affected with co-morbidity Many sufferers do not seek help 38% of people in ONS 2007 sought help Many are undiagnosed by their GP 32% of anxiety and depression undetected for 3 years 14% had disabling illness Many are untreated 24% in ONS 2007 receiving treatment (14% medication)

8 Why are they important? Depression will become most significant burden than COPD, IHD, Diabetes in 2030 (WHO) They complicate other illnesses and increase morbidity e.g., depression and stroke or IHD Increase risk of suicide

9 How do they affect sufferers? Depression Mood/Cognitive low mood low self esteem guilt & hopelessness poor attention poor concentration ruminations Behaviour/Physical Tearfulness irritability disturbed sleep loss of libido fatigue headaches aches and pains

10 Severity of common mental health disorders Mild relatively few core symptoms, a limited duration and little impact on day-to-day functioning Moderate all core symptoms of the disorder plus other related symptoms, duration beyond that required by minimum diagnostic criteria, and a clear impact on functioning Severe most or all symptoms of the disorder, often of long duration and with very marked impact on functioning Persistent sub-threshold symptoms and associated functional impairment that do not meet full diagnostic criteria but have a substantial impact on a person s life, and which are present for a significant period of time

11 Syndrome of depression Core features Low mood Decreased sense of pleasure Fatiguability and poor concentration Self-reproach Mild episode Moderate episode Severe episode Anxiety symptoms Anhedonia Exaggeration of all features of a Tearfulness Reduced concentration of a moderate episode Mood responsive to events Reduced self-esteem and confidence Negative memories and attitudes In psychotic cases: Suicidal thoughts Delusions of guilt Psychomotor retardation Auditory hallucinations Mood worse in morning Lack of insight Disturbed sleep (early waking) Depressive stupor Loss of appetite and weight Loss of libido Constipation, Amenorrhoea

12 What should you look out for? Family history of depression Past history of depression Somatic symptoms Chronic physical health problem Interpersonal relations, living conditions & life events During the last month have often been bothered by: Feeling down, depressed, or hopeless Having little interest or pleasure in doing things? Consider administering PHQ-9

13 Anxiety Disorder Common Symptoms: Mental tension excessive worry, feeling tense or nervous, poor concentration Physical tension restlessness, headaches, tremors, inability to relax Physiological arousal sweating, dizziness, pounding heart, dry mouth Often occurs in those with chronic tendency to worry Triggered by stressful events Lasting over 6 months Check physical health e.g., thyrotoxicosis Check for comorbidity

14 Other Anxiety Disorders Panic Disorder Intermittent apprehension Panic attacks May be related to specific situations or spontaneous Avoidance of situations Panic disorder with or without agoraphobia Specific Phobias Extreme and persistent disproportionate fear of object or situation Immediate anxiety or panic attack Avoidance May interfere with day to day life

15 Other Anxiety Disorders Social Anxiety Disorder Social phobia Intense fear of social situations Fear of being judged, embarrassed or humiliated Avoidance of situations Impacts on attainment at school or work Alcohol use and depression PTSD Follows one or more traumatic events Usually up to a month Common in survivors of life threatening events Re-experiencing of trauma with flashbacks, nightmares and intrusive memories Excessive anxiety with hyper vigilance, avoidance, numbness

16 Other Anxiety Disorders Obsessive Compulsive Disorders Presence of obsessions, ruminations or both Intrusive repetitive thought, image or urge Usually seen as unusual or excessive Compulsions repetitive mental acts or behaviour Considerable anxiety

17 Identification of anxiety Past history Symptoms of an anxiety disorder Recent traumatic event. Ask about feelings of anxiety and ability to stop or control worry Consider using the GAD-2 scale.

18 Identification of anxiety Consider asking: Over the last two weeks, how often have you been bothered by the following problems? Feeling nervous, anxious or on edge Not being able to stop or control worrying Generalised Anxiety Disorder Scale -2 (GAD-2) is the first two questions of the GAD-7 scale The GAD-7 tool was developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc.

19 Identification: anxiety 3 Also ask: Do you find yourself avoiding places or activities and does this cause you problems? For significant communication difficulties, consider using the Distress Thermometer and/or asking a family member or carer about the person s symptoms

20 CMHDs presentation and severity Recommended interventions Step 1 All disorders known and suspected presentations All disorders: Identification, assessment, psychoeducation, active monitoring; referral for further assessment and interventions Step 2 Persistent sub-threshold depressive symptoms or mild to moderate depression; GAD; mild to moderate panic disorder; mild to moderate OCD; PTSD (including mild to moderate) Step 3 Persistent sub-threshold depressive symptoms; mild to moderate depression not responded to a low-intensity intervention; moderate or severe depression; GAD with functional impairment or has not responded to low-intensity intervention; moderate to severe panic disorder; OCD with moderate or severe functional impairment; PTSD Depression GAD and panic disorder OCD PTSD All disorders Support groups, educational and employment support services; referral for further assessment and interventions Depression GAD Panic disorder OCD PTSD All disorders Support groups, educational and employment support services; referral for further assessment and interventions

21 Treatment of Depression NICE Guidelines (2007) Step 1: Recognition in primary care and general hospital settings Step 2: Treatment of mild depression in primary care Step 3: Treatment of moderate to severe depression in primary care Step 4: Treatment of depression by mental health specialists Step 5: Inpatient treatment for depression

22 Step 4: Treatment of depression by mental health specialists Key issues are: Compliance/dosage Suicide risk Previous history Psychosocial stressors Relationships Personality factors Clarify diagnosis & risks Provide information Consider medication change Consider CBT Consider augmentation Consider antipsychotic

23 Outcome Poor outcome often associated with early onset Relapse is higher with early and late onset disorders Treatment response 50% develop a 2 nd episode 70% develop a 3 rd episode 90% develop a 4 th episode

24 Stepped care for people with GAD Step 1 Identification and assessment; education about GAD and treatment options; active monitoring Step 2 Low-intensity psychological interventions: individual nonfacilitated self-help, individual guided self-help and psycho-educational groups Step 3 Choice of a high-intensity psychological intervention (cognitive behavioural therapy/applied relaxation) or a drug treatment Step 4 Highly specialist treatment, such as complex drug and/or psychological treatment regimens; input from multi-agency teams, crisis services, day hospitals or inpatient care

25 Referral to secondary care Severe anxiety with Marked functional impairment Poor response Comorbidity Risk risk of self-harm Suicide self-neglect

26 Specialist treatment Multiprofessional collaboration Combinations of treatment: psychological and drug treatments or combinations of antidepressants or augmentation of antidepressants with other drugs. Increased risk of side effects and limited evidence for efficacy

27 Course and Outcome Frequent attendance (GP, cardiologist and gastroenterologists) Chronic condition (60% still ill over 12years) Comorbidity is common and associated with worse outcome

28 Summary Anxiety and depression affect 1:6 adults The commonest presentation is mixed anxiety & depression Many cases are undiagnosed and untreated for years thus impairing ability to work and function Simple two-question screening tools can be useful Assessments should consider functional impairment & associated social and interpersonal difficulties Poor response or risks should prompt referral to secondary care

Taking Care: Child and Youth Mental Health ANXIETY WHAT IS IT?

Taking Care: Child and Youth Mental Health ANXIETY WHAT IS IT? Taking Care: Child and Youth Mental Health ANXIETY WHAT IS IT? Open Learning Agency 2004 WHAT IS IT? Anxiety is a normal human feeling characterized by worry, nervousness and fear. Not only does anxiety

More information

Common mental health disorders

Common mental health disorders Issue date: May 2011 Common mental health disorders Identification and pathways to care NICE clinical guideline 123 Developed by the National Collaborating Centre for Mental Health NICE clinical guideline

More information

Depression Screening in Primary Care

Depression Screening in Primary Care Depression Screening in Primary Care Toni Johnson, MD Kristen Palcisco, BA, MSN, APRN MetroHealth System Our Vision Make Greater Cleveland a healthier place to live and a better place to do business. 2

More information

Quick Guide to PRIME-MD Patient Health Questionnaire (PHQ) PHQ9 and GAD7

Quick Guide to PRIME-MD Patient Health Questionnaire (PHQ) PHQ9 and GAD7 Quick Guide to PRIME-MD Patient Health Questionnaire (PHQ) PHQ9 and GAD7 Purpose The Patient Health Questionnaire (PHQ) is designed to facilitate the recognition and diagnosis of the most common mental

More information

Mental health issues in the elderly. January 28th 2008 Presented by Éric R. Thériault etheriau@lakeheadu.ca

Mental health issues in the elderly. January 28th 2008 Presented by Éric R. Thériault etheriau@lakeheadu.ca Mental health issues in the elderly January 28th 2008 Presented by Éric R. Thériault etheriau@lakeheadu.ca Cognitive Disorders Outline Dementia (294.xx) Dementia of the Alzheimer's Type (early and late

More information

Referral Criteria for Berkshire Specialist CAMHs

Referral Criteria for Berkshire Specialist CAMHs Referral Criteria for Berkshire Specialist CAMHs Berkshire CAMHs is a specialist child and adolescent mental health service that provides support, advice, guidance and treatment for children and young

More information

Costing statement: Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults

Costing statement: Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults Costing statement: Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults Introduction The partial update of the guideline on Generalised anxiety disorder and panic disorder

More information

Some helpful reminders on depression in children and young people. Maria Moldavsky Consultant Child and Adolescent Psychiatrist

Some helpful reminders on depression in children and young people. Maria Moldavsky Consultant Child and Adolescent Psychiatrist Some helpful reminders on depression in children and young people Maria Moldavsky Consultant Child and Adolescent Psychiatrist The clinical picture What art and my patients taught me Albert Durer (1471-1528)

More information

DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource

DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource E-Resource March, 2015 DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource Depression affects approximately 20% of the general population

More information

Postpartum Depression and Post-Traumatic Stress Disorder

Postpartum Depression and Post-Traumatic Stress Disorder Postpartum Depression and Post-Traumatic Stress Disorder Emotional Recovery: Postpartum Depression and Post-Traumatic Stress Disorder By: Lisa Houchins Published: July 23, 2013 Emotions vary widely after

More information

Sunderland Psychological Wellbeing Service

Sunderland Psychological Wellbeing Service Sunderland Psychological Wellbeing Service Information for Referrers Offering a range of psychological therapies across Sunderland. To make a referral call 0191 566 5454 A partnership between Northumberland,

More information

Understanding anxiety and depression

Understanding anxiety and depression Understanding anxiety and depression www.beyondblue.org.au 1300 22 4636 Anxiety Over two million people in Australia experience anxiety each year. On average, one in three women and one in fve men will

More information

Depression Assessment & Treatment

Depression Assessment & Treatment Depressive Symptoms? Administer depression screening tool: PSC Depression Assessment & Treatment Yes Positive screen Safety Screen (see Appendix): Administer every visit Neglect/Abuse? Thoughts of hurting

More information

Presently, there are no means of preventing bipolar disorder. However, there are ways of preventing future episodes: 1

Presently, there are no means of preventing bipolar disorder. However, there are ways of preventing future episodes: 1 What is bipolar disorder? There are two main types of bipolar illness: bipolar I and bipolar II. In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated

More information

Part 1: Depression Screening in Primary Care

Part 1: Depression Screening in Primary Care Part 1: Depression Screening in Primary Care Toni Johnson, MD Kristen Palcisco, BA, MSN, APRN MetroHealth System Objectives Part 1: Improve ability to screen and diagnose Depression in Primary Care Increase

More information

Anxiety Disorders. What are anxiety disorders?

Anxiety Disorders. What are anxiety disorders? Anxiety Disorders What are anxiety disorders? Everyone knows what it's like to feel anxious-the "butterflies" in your stomach before that first date, the "jitters" before giving a speech, the sweaty palms

More information

Assessment of depression in adults in primary care

Assessment of depression in adults in primary care Assessment of depression in adults in primary care Adapted from: Identification of Common Mental Disorders and Management of Depression in Primary care. New Zealand Guidelines Group 1 The questions and

More information

Depression Flow Chart

Depression Flow Chart Depression Flow Chart SCREEN FOR DEPRESSION ANNUALLY Assess for depression annually with the PHQ-9. Maintain a high index of suspicion in high risk older adults. Consider suicide risk and contributing

More information

Mental Health Awareness. Haley Berry and Nic Roberts Nottinghamshire Mind Network

Mental Health Awareness. Haley Berry and Nic Roberts Nottinghamshire Mind Network Mental Health Awareness 2015 Haley Berry and Nic Roberts Nottinghamshire Mind Network The aim of this training:! to provide you with a basic understanding of mental health and mental illness. What do you

More information

Depression in adults with a chronic physical health problem

Depression in adults with a chronic physical health problem Depression in adults with a chronic physical health problem Treatment and management Issued: October 2009 NICE clinical guideline 91 guidance.nice.org.uk/cg91 NICE has accredited the process used by the

More information

Asthma, anxiety & depression

Asthma, anxiety & depression Anxiety and are common in people with asthma. The good news is that there are effective treatments both for asthma and for anxiety and. With careful management, the symptoms of anxiety and can be treated

More information

Anxiety Disorders. Anxiety: An unpleasant emotional state characterized by physical arousal and feelings of tension, apprehension or worry.

Anxiety Disorders. Anxiety: An unpleasant emotional state characterized by physical arousal and feelings of tension, apprehension or worry. Anxiety Disorders LP Psy Disorders BB:Psydisorder anxiety 1 Anxiety: An unpleasant emotional state characterized by physical arousal and feelings of tension, apprehension or worry. Anxiety is normal. Abnormal

More information

See also www.thiswayup.org.au/clinic for an online treatment course.

See also www.thiswayup.org.au/clinic for an online treatment course. Depression What is depression? Depression is one of the common human emotional states. It is common to experience feelings of sadness and tiredness in response to life events, such as losses or disappointments.

More information

SLEEP DISTURBANCE AND PSYCHIATRIC DISORDERS

SLEEP DISTURBANCE AND PSYCHIATRIC DISORDERS E-Resource December, 2013 SLEEP DISTURBANCE AND PSYCHIATRIC DISORDERS Between 10-18% of adults in the general population and up to 50% of adults in the primary care setting have difficulty sleeping. Sleep

More information

How to Recognize Depression and Its Related Mood and Emotional Disorders

How to Recognize Depression and Its Related Mood and Emotional Disorders How to Recognize Depression and Its Related Mood and Emotional Disorders Dr. David H. Brendel Depression s Devastating Toll on the Individual Reduces or eliminates pleasure and jo Compromises and destroys

More information

Suzanne R. Merlis, Psy. D. Georgia-LLC Licensed Psychologist

Suzanne R. Merlis, Psy. D. Georgia-LLC Licensed Psychologist Suzanne R. Merlis, Psy. D. Georgia-LLC Licensed Psychologist If going to asylum officer at affirmative stage: ASYLUM OFFICER, ARLINGTON ASYLUM OFFICE In the Matter of Mr. X Respondent If referred to judge:

More information

Supporting the return to work of employees with depression or anxiety

Supporting the return to work of employees with depression or anxiety Supporting the return to work of employees with depression or anxiety Advice for employers Around one million Australian adults live with depression. Over two million have an anxiety disorder. On average,

More information

FACT SHEET. What is Trauma? TRAUMA-INFORMED CARE FOR WORKING WITH HOMELESS VETERANS

FACT SHEET. What is Trauma? TRAUMA-INFORMED CARE FOR WORKING WITH HOMELESS VETERANS FACT SHEET TRAUMA-INFORMED CARE FOR WORKING WITH HOMELESS VETERANS According to SAMHSA 1, trauma-informed care includes having a basic understanding of how trauma affects the life of individuals seeking

More information

Post-traumatic stress disorder overview

Post-traumatic stress disorder overview Post-traumatic stress disorder overview A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways are interactive

More information

Brief Review of Common Mental Illnesses and Treatment

Brief Review of Common Mental Illnesses and Treatment Brief Review of Common Mental Illnesses and Treatment Presentations to the Joint Subcommittee to Study Mental Health Services in the 21st Century September 9, 2014 Jack Barber, M.D. Medical Director Virginia

More information

BRIEF NOTES ON THE MENTAL HEALTH OF CHILDREN AND ADOLESCENTS

BRIEF NOTES ON THE MENTAL HEALTH OF CHILDREN AND ADOLESCENTS BRIEF NOTES ON THE MENTAL HEALTH OF CHILDREN AND ADOLESCENTS The future of our country depends on the mental health and strength of our young people. However, many children have mental health problems

More information

Mild depression: Few, if any, symptoms in excess of the 5 required to make the diagnosis, and symptoms result in only minor functional impairment.

Mild depression: Few, if any, symptoms in excess of the 5 required to make the diagnosis, and symptoms result in only minor functional impairment. 6.1 Anxiety Depression - Adults Anxiety is a condition characterized by persistent worry or unease and is usually accompanied by fear, panic, irritability, poor sleep, poor concentration and avoidance,

More information

Costing statement: Depression: the treatment and management of depression in adults. (update) and

Costing statement: Depression: the treatment and management of depression in adults. (update) and Costing statement: Depression: the treatment and management of depression in adults (update) and Depression in adults with a chronic physical health problem: treatment and management Summary It has not

More information

EMOTIONAL AND BEHAVIOURAL CONSEQUENCES OF HEAD INJURY

EMOTIONAL AND BEHAVIOURAL CONSEQUENCES OF HEAD INJURY Traumatic brain injury EMOTIONAL AND BEHAVIOURAL CONSEQUENCES OF HEAD INJURY Traumatic brain injury (TBI) is a common neurological condition that can have significant emotional and cognitive consequences.

More information

Mental Health Needs Assessment Personality Disorder Prevalence and models of care

Mental Health Needs Assessment Personality Disorder Prevalence and models of care Mental Health Needs Assessment Personality Disorder Prevalence and models of care Introduction and definitions Personality disorders are a complex group of conditions identified through how an individual

More information

in young people Management of depression in primary care Key recommendations: 1 Management

in young people Management of depression in primary care Key recommendations: 1 Management Management of depression in young people in primary care Key recommendations: 1 Management A young person with mild or moderate depression should typically be managed within primary care services A strength-based

More information

PTSD IN PRIMARY CARE. Kari A. Stephens, PhD & Wayne Bentham, MD Psychiatry & Behavioral Sciences University of Washington

PTSD IN PRIMARY CARE. Kari A. Stephens, PhD & Wayne Bentham, MD Psychiatry & Behavioral Sciences University of Washington PTSD IN PRIMARY CARE Kari A. Stephens, PhD & Wayne Bentham, MD Psychiatry & Behavioral Sciences University of Washington What to expect today? Defining and assessing PTSD Approach for doing differential

More information

Mental Health & Substance Use Disorders

Mental Health & Substance Use Disorders Mental Health & Substance Use Disorders Thank you to Daniella Kanareck Dr. Arielle Taylor Overview 1. Overview of Mental Health 2. Stigma and attitudes associated with this population 3. Mental Disorders

More information

Wesley Mental Health. Depression and Anxiety Programs. Wesley Hospital Ashfield. Journey together

Wesley Mental Health. Depression and Anxiety Programs. Wesley Hospital Ashfield. Journey together Wesley Mental Health Depression and Anxiety Programs Wesley Hospital Ashfield Journey together Mission Continuing the work of Jesus Christ in Word and deed Wesley Mission is an organisation with a long

More information

Registered Charity No. 5365

Registered Charity No. 5365 THE MULTIPLE SCLEROSIS SOCIETY OF IRELAND Dartmouth House, Grand Parade, Dublin 6. Telephone: (01) 269 4599. Fax: (01) 269 3746 MS Helpline: 1850 233 233 E-mail: mscontact@ms-society.ie www.ms-society.ie

More information

ANXIETY DISORDERS. TASK: Recognize warning signs and symptoms of Anxiety Disorders.

ANXIETY DISORDERS. TASK: Recognize warning signs and symptoms of Anxiety Disorders. TASK: Recognize warning signs and symptoms of Anxiety Disorders. STANDARDS: Soldiers will understand how recognize signs of anxiety and better assist others when one may be having symptoms or showing signs

More information

Major Depressive Disorder (MDD) Guideline Diagnostic Nomenclature for Clinical Depressive Conditions

Major Depressive Disorder (MDD) Guideline Diagnostic Nomenclature for Clinical Depressive Conditions Major Depressive Disorder Major Depressive Disorder (MDD) Guideline Diagnostic omenclature for Clinical Depressive Conditions Conditions Diagnostic Criteria Duration Major Depression 5 of the following

More information

Dr. Anna M. Acee, EdD, ANP-BC, PMHNP-BC Long Island University, Heilbrunn School of Nursing

Dr. Anna M. Acee, EdD, ANP-BC, PMHNP-BC Long Island University, Heilbrunn School of Nursing Dr. Anna M. Acee, EdD, ANP-BC, PMHNP-BC Long Island University, Heilbrunn School of Nursing Overview Depression is significantly higher among elderly adults receiving home healthcare, particularly among

More information

Post-traumatic stress disorder (PTSD): the treatment of PTSD in adults and children

Post-traumatic stress disorder (PTSD): the treatment of PTSD in adults and children Post-traumatic stress disorder (PTSD): the treatment of PTSD in adults and children Understanding NICE guidance information for people with PTSD, their advocates and carers, and the public March 2005 Information

More information

Depression in Adults

Depression in Adults Depression in Adults A chapter of Croydon s mental health Joint Strategic Needs Assessment 2012/13 Health and Wellbeing Board 5 December 2012 Bernadette Alves, Locum Consultant in Public Health Croydon

More information

Welcome New Employees. Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders

Welcome New Employees. Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious

More information

Children s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT

Children s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT Children s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT Please fax with CCHP prior authorization form to 608-252-0853

More information

Mental Health Ombudsman Training Manual. Advocacy and the Adult Home Resident. Module V: Substance Abuse and Common Mental Health Disorders

Mental Health Ombudsman Training Manual. Advocacy and the Adult Home Resident. Module V: Substance Abuse and Common Mental Health Disorders Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase

More information

HEALTH REPORT ISSUE #32

HEALTH REPORT ISSUE #32 ISSUE #32 DEPRESSION AND CHRONIC ILLNESS This edition of the Health Report looks at depression and chronic illness. Depression is a very real condition for many people living with a chronic illness, which

More information

Generalised anxiety disorder in adults

Generalised anxiety disorder in adults www.bpac.org.nz keyword: anxiety Generalised anxiety disorder in adults diagnosis and management Key concepts: Anxiety disorders are the most frequently seen mental disorders in primary care Generalised

More information

When You Are More Than Down in the Dumps Depression in Older Adults

When You Are More Than Down in the Dumps Depression in Older Adults When You Are More Than Down in the Dumps Depression in Older Adults Revised by M. Smith (2006) from K.C. Buckwalter & M. Smith (1993), When You Are More Than Down in the Dumps : Depression in the Elderly,

More information

9/11Treatment Referral Program How to Get Care

9/11Treatment Referral Program How to Get Care 9/11Treatment Referral Program How to Get Care Health 9/11 Treatment Referral Program The 9/11 Treatment Referral Program was created to help enrollees and others find care for WTC-related health problems.

More information

Symptoms of mania can include: 3

Symptoms of mania can include: 3 Bipolar Disorder This factsheet gives information on bipolar disorder. It explains the symptoms of bipolar disorder, treatments and ways to manage symptoms. It also covers what treatment the National Institute

More information

Post Traumatic Stress Disorder & Substance Misuse

Post Traumatic Stress Disorder & Substance Misuse Post Traumatic Stress Disorder & Substance Misuse Produced and Presented by Dr Derek Lee Consultant Chartered Clinical Psychologist Famous Sufferers. Samuel Pepys following the Great Fire of London:..much

More information

NICE clinical guideline 90

NICE clinical guideline 90 Depression in adults The treatment and management of depression in adults Issued: October 2009 NICE clinical guideline 90 guidance.nice.org.uk/cg90 NHS Evidence has accredited the process used by the Centre

More information

More than just feelings of unhappiness, clinical or major depression is a mood disorder a medical illness that involves both the body and mind.

More than just feelings of unhappiness, clinical or major depression is a mood disorder a medical illness that involves both the body and mind. What is depression? More than just feelings of unhappiness, clinical or major depression is a mood disorder a medical illness that involves both the body and mind. 1,2 The difference between clinical depression

More information

DEPRESSION CARE PROCESS STEP EXPECTATIONS RATIONALE

DEPRESSION CARE PROCESS STEP EXPECTATIONS RATIONALE 1 DEPRESSION CARE PROCESS STEP EXPECTATIONS RATIONALE ASSESSMENT/PROBLEM RECOGNITION 1. Did the staff and physician seek and document risk factors for depression and any history of depression? 2. Did staff

More information

Major Depression. What is major depression?

Major Depression. What is major depression? Major Depression What is major depression? Major depression is a serious medical illness affecting 9.9 million American adults, or approximately 5 percent of the adult population in a given year. Unlike

More information

Depression in the Elderly: Recognition, Diagnosis, and Treatment

Depression in the Elderly: Recognition, Diagnosis, and Treatment Depression in the Elderly: Recognition, Diagnosis, and Treatment LOUIS A. CANCELLARO, PhD, MD, EFAC Psych Professor Emeritus and Interim Chair ETSU Department of Psychiatry & Behavioral Sciences Diagnosis

More information

A Sierra Tucson Publication. An Introduction to Mood Disorders & Treatment Options

A Sierra Tucson Publication. An Introduction to Mood Disorders & Treatment Options A Sierra Tucson Publication An Introduction to Mood Disorders & Treatment Options 0 Introduction The term mood disorder refers to a category that includes the following mental health issues: Anxiety Disorders

More information

Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD) Issue date: March 2005 Quick reference guide Post-traumatic stress disorder (PTSD) The management of PTSD in adults and children in primary and secondary care Clinical Guideline 26 Developed by the National

More information

Wesley Mental Health. Depression and Anxiety Programs. Wesley Hospital Kogarah. Journey together

Wesley Mental Health. Depression and Anxiety Programs. Wesley Hospital Kogarah. Journey together Wesley Mental Health Depression and Anxiety Programs Wesley Hospital Kogarah Journey together Mission Continuing the work of Jesus Christ in Word and deed Wesley Mission is an organisation with a long

More information

Depression and its Treatment in Older Adults. Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City

Depression and its Treatment in Older Adults. Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City Depression and its Treatment in Older Adults Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City What is Depression? Everyday use of the word Clinically significant depressive symptoms : more severe,

More information

Step 4: Complex and severe depression in adults

Step 4: Complex and severe depression in adults Step 4: Complex and severe depression in adults A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways are interactive

More information

MOLINA HEALTHCARE OF CALIFORNIA

MOLINA HEALTHCARE OF CALIFORNIA MOLINA HEALTHCARE OF CALIFORNIA MAJOR DEPRESSION IN ADULTS IN PRIMARY CARE HEALTH CARE GUIDELINE (ICSI) Health Care Guideline Twelfth Edition May 2009. The guideline was reviewed and adopted by the Molina

More information

B i p o l a r D i s o r d e r

B i p o l a r D i s o r d e r B i p o l a r D i s o r d e r Professor Ian Jones Director National Centre for Mental Health www.ncmh.info @ncmh_wales /WalesMentalHealth 029 2074 4392 info@ncmh.info Robert Schumann 1810-1856 Schumann's

More information

Elizabeth A. Crocco, MD Assistant Clinical Professor Chief, Division of Geriatric Psychiatry Department of Psychiatry and Behavioral Sciences Miller

Elizabeth A. Crocco, MD Assistant Clinical Professor Chief, Division of Geriatric Psychiatry Department of Psychiatry and Behavioral Sciences Miller Elizabeth A. Crocco, MD Assistant Clinical Professor Chief, Division of Geriatric Psychiatry Department of Psychiatry and Behavioral Sciences Miller School of Medicine/University of Miami Question 1 You

More information

Identifying and Treating Dual-Diagnosed Substance Use and Mental Health Disorders. Presented by: Carrie Terrill, LCDC

Identifying and Treating Dual-Diagnosed Substance Use and Mental Health Disorders. Presented by: Carrie Terrill, LCDC Identifying and Treating Dual-Diagnosed Substance Use and Mental Health Disorders Presented by: Carrie Terrill, LCDC Overview What is Dual Diagnosis? How Common is Dual Diagnosis? What are Substance Use

More information

Clinical guideline Published: 28 October 2009 nice.org.uk/guidance/cg90

Clinical guideline Published: 28 October 2009 nice.org.uk/guidance/cg90 Depression in adults: recognition and management Clinical guideline Published: 28 October 2009 nice.org.uk/guidance/cg90 NICE 2009. All rights reserved. Last updated April 2016 Your responsibility The

More information

Depression & Multiple Sclerosis

Depression & Multiple Sclerosis Depression & Multiple Sclerosis Managing specific issues Aaron, diagnosed in 1995. The words depressed and depression are used so casually in everyday conversation that their meaning has become murky.

More information

InDependent Diabetes Trust

InDependent Diabetes Trust InDependent Diabetes Trust Diabetes Stress, Anxiety and Depression Updated January 2013 Registered Company Number 3148360 Registered Charity No 1058284 Contents Introduction Stress and diabetes How the

More information

Memory, Behaviour, Emotional and Personality Changes after a Brain Injury

Memory, Behaviour, Emotional and Personality Changes after a Brain Injury Memory, Behaviour, Emotional and Personality Changes after a Brain Injury The consequences of a brain injury on any individual, family or relationship are far reaching. A brain injury not only impacts

More information

What? Me Worry!?! Module 1. Overview of Generalised Anxiety

What? Me Worry!?! Module 1. Overview of Generalised Anxiety Module 1 Overview of Generalised Anxiety ntroduction 2 Understanding Anxiety 2 Understanding Generalised Anxiety 3 What Causes Generalised Anxiety? 5 Module Summary 6 Page 1 ntroduction What? Me worry?

More information

Depression & Multiple Sclerosis. Managing Specific Issues

Depression & Multiple Sclerosis. Managing Specific Issues Depression & Multiple Sclerosis Managing Specific Issues Feeling blue The words depressed and depression are used so casually in everyday conversation that their meaning has become murky. True depression

More information

POST-TRAUMATIC STRESS DISORDER PTSD Diagnostic Criteria PTSD Detection and Diagnosis PC-PTSD Screen PCL-C Screen PTSD Treatment Treatment Algorithm

POST-TRAUMATIC STRESS DISORDER PTSD Diagnostic Criteria PTSD Detection and Diagnosis PC-PTSD Screen PCL-C Screen PTSD Treatment Treatment Algorithm E-Resource March, 2014 POST-TRAUMATIC STRESS DISORDER PTSD Diagnostic Criteria PTSD Detection and Diagnosis PC-PTSD Screen PCL-C Screen PTSD Treatment Treatment Algorithm Post-traumatic Stress Disorder

More information

Depression. The treatment and management of depression in adults. This is a partial update of NICE clinical guideline 23

Depression. The treatment and management of depression in adults. This is a partial update of NICE clinical guideline 23 Issue date: October 2009 Depression The treatment and management of depression in adults This is a partial update of NICE clinical guideline 23 NICE clinical guideline 90 Developed by the National Collaborating

More information

Psychosis Psychosis-substance use Bipolar Affective Disorder Programmes EASY JCEP EPISO Prodrome

Psychosis Psychosis-substance use Bipolar Affective Disorder Programmes EASY JCEP EPISO Prodrome Dr. May Lam Assistant Professor, Department of Psychiatry, The University of Hong Kong Psychosis Psychosis-substance use Bipolar Affective Disorder Programmes EASY JCEP EPISO Prodrome a mental state in

More information

Bipolar Disorder. When people with bipolar disorder feel very happy and "up," they are also much more active than usual. This is called mania.

Bipolar Disorder. When people with bipolar disorder feel very happy and up, they are also much more active than usual. This is called mania. Bipolar Disorder Introduction Bipolar disorder is a serious mental disorder. People who have bipolar disorder feel very happy and energized some days, and very sad and depressed on other days. Abnormal

More information

A Bird s s Eye View of depression and unexplained somatic symptoms in primary care

A Bird s s Eye View of depression and unexplained somatic symptoms in primary care A Bird s s Eye View of depression and unexplained somatic symptoms in primary care Wanchai, Hong Kong 2 nd March 2005 David Goldberg Institute of Psychiatry King s s College, London Six parts to the lecture:

More information

Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD) Post-Traumatic Stress Disorder (PTSD) Post traumatic stress disorder is a condition where you have recurring distressing memories, flashbacks, and other symptoms after suffering a traumatic event. Treatment

More information

Depression Signs & Symptoms

Depression Signs & Symptoms Depression Signs & Symptoms Contents What Is Depression? What Are The Signs And Symptoms Of Depression? How Do The Signs And Symptoms Of Depression Differ In Different Groups? What Are The Different Types

More information

mpv`elildf`^i=qob^qjbkqp=ñçê= ^åñáéíó=~åç=aééêéëëáçå h~íó=dê~òéäêççâ `äáåáå~ä=ié~çi=dêééåïáåü=qáãé=qç=q~äâ `çåëìäí~åí=`äáåáå~ä=mëóåüçäçöáëí

mpv`elildf`^i=qob^qjbkqp=ñçê= ^åñáéíó=~åç=aééêéëëáçå h~íó=dê~òéäêççâ `äáåáå~ä=ié~çi=dêééåïáåü=qáãé=qç=q~äâ `çåëìäí~åí=`äáåáå~ä=mëóåüçäçöáëí mpv`elildf`^i=qob^qjbkqp=ñçê= ^åñáéíó=~åç=aééêéëëáçå h~íó=dê~òéäêççâ `äáåáå~ä=ié~çi=dêééåïáåü=qáãé=qç=q~äâ `çåëìäí~åí=`äáåáå~ä=mëóåüçäçöáëí Plan of the presentation Summary of NICE recommended psychological

More information

Psychiatric Issues and Defense Base Act Claims. Dr. Michael Hilton

Psychiatric Issues and Defense Base Act Claims. Dr. Michael Hilton Psychiatric Issues and Defense Base Act Claims Dr. Michael Hilton Criteria for DSM-IVRPosttraumatic Stress Disorder with changes now in effect with DSM5 a. The person has been exposed to a traumatic event

More information

Managing depression after stroke. Presented by Maree Hackett

Managing depression after stroke. Presented by Maree Hackett Managing depression after stroke Presented by Maree Hackett After stroke Physical changes We can see these Depression Emotionalism Anxiety Confusion Communication problems What is depression? Category

More information

Dual Diagnosis Nursing Care: Treating the Patient with Co-Occurring Addiction & Mental Health Disorders. Deborah Koivula R.N.

Dual Diagnosis Nursing Care: Treating the Patient with Co-Occurring Addiction & Mental Health Disorders. Deborah Koivula R.N. Dual Diagnosis Nursing Care: Treating the Patient with Co-Occurring Addiction & Mental Health Disorders. Deborah Koivula R.N. Webinar Overview & Objectives I. Review current trends in co-occurring disorders

More information

Depression and anxiety disorders in women

Depression and anxiety disorders in women Depression and anxiety disorders in women Fact sheet 13 Good mental health is essential to the overall health of both men and women, but women experience some mental health problems (including depression,

More information

Intake Form. Marital Status: Date of Birth: Street Address: City: State: Zip: Home Phone: Cell Phone: Work Phone: Social Security #:

Intake Form. Marital Status: Date of Birth: Street Address: City: State: Zip: Home Phone: Cell Phone: Work Phone: Social Security #: Intake Form PATIENT INFORMATION Patient Last Name: First Name: Marital Status: Date of Birth: Street Address: City: State: Zip: Home Phone: Cell Phone: Work Phone: Social Security #: Gender: Employer:

More information

information for service providers Schizophrenia & Substance Use

information for service providers Schizophrenia & Substance Use information for service providers Schizophrenia & Substance Use Schizophrenia and Substance Use Index 2 2 3 5 6 7 8 9 How prevalent are substance use disorders among people with schizophrenia? How prevalent

More information

Evaluating Dimensions of

Evaluating Dimensions of Evaluating Dimensions of Geriatric Depression and Anxiety Joel E. Streim, MD Professor, Psychiatry Geriatric Psychiatry Section University of Pennsylvania VISN 4 MIRECC Philadelphia VA Medical Center Philadelphia,

More information

Helping people to live life their way

Helping people to live life their way Occupational therapy and Depression Occupational therapy can help people Occupational therapy Dealing Depression is a common illness that affects people of all ages. Depression may occur for no apparent

More information

Seniors and. Depression. What You Need to Know. Behavioral Healthcare Options, Inc.

Seniors and. Depression. What You Need to Know. Behavioral Healthcare Options, Inc. Seniors and Depression What You Need to Know Behavioral Healthcare Options, Inc. Depression More Than Just The Blues ou may not know exactly what is wrong with you, but you do know that you just don t

More information

Understanding Stress, Anxiety, Depression & Burnout

Understanding Stress, Anxiety, Depression & Burnout Understanding Stress, Anxiety, Depression & Burnout Data Deliver over 18,000 hours of counselling and psychological assessments mental health trends emerge. Depression drives the most cases as primary

More information

Traumatic Stress. and Substance Use Problems

Traumatic Stress. and Substance Use Problems Traumatic Stress and Substance Use Problems The relation between substance use and trauma Research demonstrates a strong link between exposure to traumatic events and substance use problems. Many people

More information

PSYCHOLOGICAL DISORDERS

PSYCHOLOGICAL DISORDERS 20 PSYCHOLOGICAL DISORDERS Feeling happy, or crying when one is hurt, are some common actions which we all engage in some time or the other. Most of the time we act as the situation demands us to, that

More information

Anxiety Disorders. How Common Are Anxiety Disorders?

Anxiety Disorders. How Common Are Anxiety Disorders? F A C T S A B O U T Anxiety s Most people experience feelings of anxiety before an important event such as a big exam, business presentation, or first date. Anxiety disorders, however, are illnesses that

More information

Psychological Impact of Disasters Clinical and General Approaches

Psychological Impact of Disasters Clinical and General Approaches Psychological Impact of Disasters Clinical and General Approaches Dr.V.D.Swaminathan Professor of Psychology & Director in charge University Students Advisory Bureau, University of Madras Disaster means

More information

WHAT IS PTSD? A HANDOUT FROM THE NATIONAL CENTER FOR PTSD BY JESSICA HAMBLEN, PHD

WHAT IS PTSD? A HANDOUT FROM THE NATIONAL CENTER FOR PTSD BY JESSICA HAMBLEN, PHD WHAT IS PTSD? A HANDOUT FROM THE NATIONAL CENTER FOR PTSD BY JESSICA HAMBLEN, PHD Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can occur following the experience or witnessing of a

More information

Sex and Love Addiction

Sex and Love Addiction Sex and Love Addiction Yes, love and sex can be addictive and as destructive, at least socially, as compulsive substance use. The high hinges on physical or psychological arousal, and relationships can

More information

Treatment Bulletin. Anxiety, Depression & HIV. Toronto People With AIDS Foundation

Treatment Bulletin. Anxiety, Depression & HIV. Toronto People With AIDS Foundation Toronto People With AIDS Foundation Treatment Bulletin Anxiety, Depression & HIV January 2010 No. 1 Disclaimer Permission to Reproduce The Treatment Resources Program at the Toronto People With AIDS Foundation

More information

Depre r s e sio i n o i n i a dults Yousuf Al Farsi

Depre r s e sio i n o i n i a dults Yousuf Al Farsi Depression in adults Yousuf Al Farsi Objectives 1. Aetiology 2. Classification 3. Major depression 4. Screening 5. Differential diagnosis 6. Treatment approach 7. When to refer 8. Complication 9. Prognosis

More information