Video on Medical Evaluation in Depression – 10 point guide for Psychiatrists
Posted on: May 6, 2020
Last Updated: May 6, 2020
In this Hub Bites video, Dr Sanil Rege covers the main aspects for psychiatrists to consider in a medical evaluation for patients presenting with depression. These aspects may also apply to patients with mood disorders in general.
Areas to cover:
- Vital signs – pulse and BP
- Examination of hands and arms for signs of an eating disorder, self-harm or substance use
- Respiratory system – Obstructive sleep apnoea, sleep disorders, lung malignancy
- Organ insufficiency – oedema, hepatic encephalopathy, renal dysfunction
- Endocrine disorders – thyroid dysfunction, Cushing’s disease, Addison’s disease, OC pills
- Neurological evaluation – parkinsonism, movement disorders, the neurological exam for TIA and CV disease, Multiple sclerosis
- Metabolic Profile (BMI, Waist circumference) – Antidepressants and AntiPsychotic medications leading to metabolic dysfunction
- Cardiac evaluation – ECG and effect of medications on Qtc interval
- Blood evaluation – neutropenia, pharmacokinetic dose adjustments in poor renal and liver function, Vit B12, Folate, and Vit D deficiency, Hyponatraemia (SIADH with antidepressants ), GI bleeding risk in elderly
- Urine – Urine drug screen and Midstream urine for infection