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:

  1. Vital signs – pulse and BP
  2. Examination of hands and arms for signs of an eating disorder, self-harm or substance use
  3. Respiratory system – Obstructive sleep apnoea, sleep disorders, lung malignancy
  4. Organ insufficiency – oedema, hepatic encephalopathy, renal dysfunction
  5. Endocrine disorders – thyroid dysfunction, Cushing’s disease, Addison’s disease, OC pills
  6. Neurological evaluation – parkinsonism, movement disorders, the neurological exam for TIA and CV disease, Multiple sclerosis
  7. Metabolic Profile (BMI, Waist circumference) – Antidepressants and AntiPsychotic medications leading to metabolic dysfunction
  8. Cardiac evaluation – ECG and effect of medications on Qtc interval
  9. 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
  10. Urine – Urine drug screen and Midstream urine for infection