GC017 Common Mental Health Problems In Primary Care
Common mental health problems in primary care are frequently encountered psychiatric conditions—principally depression, anxiety disorders, and stress-related disorders—that are initially identified and managed by general practitioners in the community setting.
Common Mental Health Problems in Primary Care
Lecture Map
Most mental health problems that exist in the community never reach a psychiatrist. They present first — and often only — to the primary care physician. The family doctor's job is to detect what is frequently hidden behind somatic complaints, use validated screening tools appropriately (but not confuse screening with diagnosis), and know when and how to explore mood, anxiety, and suicidality. This lecture, delivered by Prof. Amy Ng (HKU FMPC), is a high-yield target for GC-related exam questions on depression screening, PHQ-2/PHQ-9, GAD-7, medically unexplained physical symptoms (MUPS), insomnia assessment, and the patient-centred approach to psychological distress in primary care.
1. Understand the primary care approach to diagnosing patients with depression, anxiety, and undifferentiated psychological distress. [1]
2. Recognize the relationship between psychological distress and unexplained physical symptoms. [1]
3. Know some patient-centred strategies for assessing a depressed patient. [1]
Psychological symptoms are common in the general population, affecting more than 50% of adults at some time. [1]
The three most common psychological complaints people experience at some point are:
- Worry
- Tiredness
- Sleep disturbance
These are almost universal human experiences. Having them does not mean you have a psychiatric disorder — a vital distinction the lecture emphasizes.
Approximately 1 in 7 may have a diagnosable mental disorder. The two most common are Depression and Anxiety Disorders (including GAD, panic disorder, OCD, PTSD, phobias). [1]
Under-detection is the Norm
There is widespread under-detection of depression and anxiety disorders by doctors — more than 50% are missed. [1] This statistic comes from a Hong Kong primary-care study (Chin et al., 2014). The main reasons are: (a) patients present with somatic symptoms, not psychological ones; (b) doctors don't ask; (c) short consultation times; (d) stigma. This is a favourite exam point — they love testing your awareness that mental health conditions are commonly missed.
Not all patients present with psychological symptoms; many present with somatic symptoms. [1]
Why does this matter from first principles? Some patients communicate distress through bodily symptoms, either because those symptoms are the most salient part of their experience or because psychological language feels unfamiliar or stigmatising. Do not assume that a somatic presentation is “not real,” and do not assume that culture or ethnicity explains an individual patient. The GP's task is to assess physical and psychosocial possibilities together.
2. Screening Tools — PHQ-2, PHQ-9, GAD-7
Critical Concept: Screening ≠ Diagnosis
These are NOT stand-alone diagnostic tools. [1] A positive screen prompts a clinical assessment of symptoms, duration, course, impairment, differential diagnoses, bipolarity and safety. A low score also does not overrule strong clinical concern. [11,13]
The PHQ-2 is the simplest entry-level screen for depression. It asks two questions about the past 2 weeks:
| Item | 0 | 1 | 2 | 3 |
|---|---|---|---|---|
| Little interest or pleasure in doing things | Not at all | Several days | More than half the days | Nearly every day |
| Feeling down, depressed, or hopeless | Not at all | Several days | More than half the days | Nearly every day |
Scoring: Total 0–6.
Positive if cut-off ≥ 3 → sensitivity 84%, specificity 90% for major depression. [1]
Why these two questions? Because they capture the two cardinal symptom domains of major depression in DSM-5 — low mood and anhedonia (loss of interest/pleasure). If a patient scores ≥ 3, proceed to the full PHQ-9; proceed on clinical concern even when the score is lower.
Clinical use: The PHQ-2 is recommended in the Hong Kong Reference Framework for Preventive Care for Older Adults — i.e., it can be used opportunistically during routine health assessments.
The nine items of the PHQ-9 map onto the nine symptom domains for major depressive disorder in DSM-5. [1]
| # | Item (Over the past 2 weeks…) | What it maps to in DSM-5 |
|---|---|---|
| 1 | Little interest or pleasure in doing things | Anhedonia |
| 2 | Feeling down, depressed, or hopeless | Low mood |
| 3 | Trouble falling asleep, staying asleep, or sleeping too much | Sleep disturbance |
| 4 | Feeling tired or having little energy | Fatigue |
| 5 | Poor appetite or overeating | Change in appetite/weight |
| 6 | Feeling bad about yourself, feeling that you are a failure, or that you have let yourself/your family down | Worthlessness/guilt |
| 7 | Trouble concentrating on things such as reading the newspaper or watching television | Lost concentration |
| 8 | Moving or speaking so slowly that other people could have noticed; OR the opposite — being so fidgety or restless | Psychomotor agitation/retardation |
| 9 | Thinking that you would be better off dead or that you want to hurt yourself in some way | Suicidal ideation |
Scoring: Each item 0–3, same scale as PHQ-2. Total 0–27.
PHQ-9 Score Interpretation: [1]
| Total Score | Severity |
|---|---|
| 0–4 | None/minimal symptoms by score (does not rule out depression) |
| 5–9 | Mild depression |
| 10–14 | Moderate depression |
| 15–19 | Moderately severe depression |
| 20–27 | Severe depression |
PHQ-9 score ≥ 10 for major depression → sensitivity 88%, specificity 88%. [1]
Key Features of PHQ-9 (from lecture):
- Short and quick [1]
- Can be administered in person, by telephone, or self-administered [1]
- Supports assessment of probable major depression but does not establish the diagnosis by itself [1,11]
- Assesses symptom severity and useful for monitoring treatment responses [1]
- Validated [1]
- Can be used in adolescents as young as 12 years of age [1]
Exam Trap: PHQ-2 vs PHQ-9
A common MCQ asks which instrument to use next when a patient presents with low mood and anhedonia. If they have NOT been screened yet, PHQ-2 is a reasonable first step. If PHQ-2 is positive (≥ 3), or if you already have a strong clinical suspicion, go to PHQ-9 for severity assessment. A 2022 past paper (Q80) tested exactly this: a 35-year-old woman with low mood and loss of interest — the answer was PHQ-9 (not PHQ-2), because enough information was already given to warrant the fuller instrument. [3]
7-item scale, based on DSM-5 symptom domains, for identifying likely cases of generalized anxiety. Validated. [1]
| # | Item (Over the past 2 weeks…) |
|---|---|
| 1 | Feeling nervous, anxious, or on edge |
| 2 | Being unable to stop or control worrying |
| 3 | Worrying too much about different things |
| 4 | Trouble relaxing |
| 5 | Being so restless that it is hard to sit still |
| 6 | Becoming easily annoyed or irritable |
| 7 | Feeling afraid as if something awful might happen |
Scoring: Same 0–3 scale. Total 0–21.
GAD-7 Score Interpretation: [1]
| Total Score | Level of Anxiety |
|---|---|
| 0–4 | None/minimal symptoms by score (does not rule out an anxiety disorder) |
| 5–9 | Mild anxiety |
| 10–14 | Moderate anxiety |
| 15–21 | Severe anxiety |
GAD-7 ≥ 10 for GAD → sensitivity 89%, specificity 82%. [1]
Can also be used as a quick tool to assess for other anxiety disorders (panic, social anxiety, PTSD). [1]
3. DSM-5 Diagnostic Criteria
The slide's core rule is at least 5 symptoms during the same 2-week period, with low mood and/or anhedonia among them. [1]
The nine symptoms are:
| # | Symptom | Mnemonic aid |
|---|---|---|
| 1 | Low mood | Must have (1) and/or (2) |
| 2 | Loss of interest (anhedonia) | Must have (1) and/or (2) |
| 3 | Sleep disturbance | |
| 4 | Lost concentration | |
| 5 | Fatigue | |
| 6 | Change in appetite or weight | |
| 7 | Agitation/retardation | |
| 8 | Feelings of worthlessness or guilt | |
| 9 | Suicidal thoughts |
A useful mnemonic: SIG E CAPS (Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor changes, Suicidality) — plus Mood.
All four additional criteria must also be met: [1]
- Symptoms cause significant impairment in social/occupational/other areas of function
- Not attributable to physiological effects of a substance or other medical condition
- Not explained by other schizophrenia/affective disorders
- No history of manic/hypomanic episodes (which would make it bipolar disorder)
Why 'No manic/hypomanic episodes'?
If a patient has even one manic or hypomanic episode, the diagnosis shifts to bipolar disorder, which has fundamentally different treatment implications (e.g., antidepressant monotherapy can precipitate mania in bipolar). This is why taking a history of past mania is critical before labelling someone as having MDD.
Characterized by excessive anxiety and worry occurring more days than not for at least 6 months about a number of events or activities. [1]
The person finds it difficult to control the worry and it is associated with 3 or more of: [1]
- Restlessness or feeling keyed up or on edge
- Being easily fatigued
- Difficulty concentrating or the mind going blank
- Irritability
- Muscle tension
- Sleep disturbance
Additional criteria: [1]
- Must cause significant distress or significantly impair social or occupational functioning
- Cannot be accounted for by substance use or a general medical disorder
Exam Discriminator: Depression vs GAD
A 2023 past paper (Q75) asked which symptom is MOST suggestive of depression over GAD in a patient with overlapping features. The overlapping features were: difficulty falling asleep, loss of concentration, muscle tension, weight gain. The answer was weight gain — because muscle tension is much more characteristic of GAD, and the other two (insomnia, poor concentration) are shared. Weight/appetite changes are listed as a DSM-5 criterion for MDD but not for GAD. [4]
In Primary Care, 18.5% of consultations are MUPS. [1]
Other terms used: "somatic", "functional", "unexplained", "dissociative". [1]
Why do patients present this way? From a biopsychosocial perspective:
- Physiological amplification: stress activates the sympathetic nervous system and HPA axis, producing real physical symptoms (palpitations, dry mouth, chest tightness, GI dysmotility).
- Cultural factors: in many Asian cultures, it is more acceptable to present with a physical complaint than an emotional one.
- Cognitive factors: illness-related beliefs, alexithymia (difficulty identifying/expressing emotions). [2]
Actively search for psychosocial stress. Ask about sleep first. If positive, ask about mood/anxiety. [1]
This is a key clinical pearl from the lecture: sleep is the gateway question. Patients will often admit to sleep difficulties more readily than to feeling depressed. Once they open up about poor sleep, you can naturally transition to asking about mood, worries, and functioning.
Common somatic presentations of mental health problems (from lecture illustration): [1]
- Headache
- Tiredness/fatigue
- Body aches ("flu-like")
- Bloating
- Dry mouth
- Shortness of breath
High Yield: MUPS in Primary Care
Approximately 1 in 5 primary care consultations involves MUPS. Always consider underlying depression or anxiety when no physical cause is found. Use sleep as a gateway question. [1]
5. Insomnia Assessment in Primary Care
The slide reports that one third of primary-care patients experience occasional sleep problems and about 10% of adults experience persistent insomnia. [1]
Update the slide-era duration
The slide's “three nights per week for one month” definition comes from an older source. Current clinical definitions use sleep difficulty despite adequate opportunity, associated daytime impairment, occurring at least 3 nights per week for at least 3 months for chronic insomnia. A 1–2 week sleep diary can help characterise the pattern. [12]
- Difficulty falling asleep (sleep-onset insomnia — think anxiety, poor sleep hygiene)
- Difficulty maintaining sleep (sleep-maintenance insomnia — think depression, pain, OSA)
- Waking up too early (early morning awakening — classic for depression)
- Non-refreshing sleep
- Fatigue
- Lack of energy
- Difficulty concentrating
- Irritability
The lecture provides a detailed list of assessment questions. These are important because they cover not just the symptom but the differential diagnosis of insomnia:
| Question | What it helps rule in/out |
|---|---|
| How has the patient been sleeping recently? | Baseline |
| When did the problem begin? | Acute vs chronic insomnia |
| Does the patient have a psychiatric or medical condition? | Secondary insomnia |
| Is the sleep environment conducive to sleep? | Environmental factors |
| "Creeping, crawling or uncomfortable feelings" in the legs relieved by moving? | Restless legs syndrome |
| Legs or arms jerk during sleep (bed partner report)? | Periodic limb movements |
| Loud snoring, gasping, choking, or stops breathing? | Obstructive sleep apnoea |
| Shift worker? Adolescent? | Circadian rhythm disorders |
| Bedtimes/rise times on weekdays vs weekends? | Poor sleep hygiene |
| Caffeine, tobacco, alcohol? Stimulating medications (antidepressants, steroids, decongestants, beta-blockers)? | Substance-induced insomnia |
| Daytime consequences? | Severity/functional impact |
| Dozing off during routine tasks, especially driving? | Dangerous — needs urgent attention |
What the sleep-assessment slide is visually organising: move from the symptom to four branches—pattern and duration, sleep opportunity/environment, mimics and comorbidity (OSA, restless legs, periodic limb movements, mood/medical illness), and substances/medicines plus daytime safety. This prevents “insomnia = hypnotic prescription” thinking.
Exam Tip: Insomnia as a Presenting Complaint
A 2025 past paper (Q19) presented a 36-year-old clerk seeking hypnotics for sleep problems with "unhappy events." The correct answer was that symptoms of psychiatric comorbidity should be explored — not which hypnotic to prescribe. [5] This directly reflects the lecture's teaching: when a patient presents with insomnia, always look for the underlying cause, especially depression and anxiety.
6. Assessing the Depressed Patient — Patient-Centred Strategies
The lecture provides a list of questions that a GP can use to explore depression in a patient-centred way: [1]
Opening / Exploring:
- What do you think is the matter with you?
- Do you think your feelings are possibly caused by nerves, anxiety, or depression?
- Can you think of any reason why you feel this way?
Mood:
- Do you feel down in the dumps?
- Do you feel that you are not coping well? / How are you coping with this?
- Do you have any good times?
Life events:
- Has anything changed in your life?
Sleep:
- How do you sleep? Do you wake early?
Diurnal variation:
- What time of the day do you feel at your worst? (Classic for melancholic depression — worse in the morning)
Severity rating:
- Where would you put yourself between 0% and 100%?
Hopelessness:
- Have you felt hopeless?
Neurovegetative:
- What is your energy like?
- What is your appetite like?
- Are you as interested in sex as before?
Guilt:
- Do you feel guilty about anything?
Hidden distress:
- Do you cry when no one is around?
The lecture highlights a video case showing a young male patient:
Males often will not express sadness, depression, crying, or hopelessness. Instead, they may experience frustration, anxiety, irritability, and anger, and may have somatic concerns. [1]
Why? Social norms around masculinity often discourage men from expressing vulnerability. The clinical consequence is that asking "are you sad?" may get a blank stare, whereas asking "have you been feeling more irritable/angry than usual?" opens the door.
Key clinical pearls from the video analysis: [1]
- Patients are often "sent in" by family — the patient may not think they have a problem.
- Males are much more comfortable talking about the physical aspects and somatic presentation of their distress.
- When asking about sensitive topics (drugs, alcohol), signposting may be helpful — e.g., "I'm going to ask some routine questions that I ask everyone."
- The doctor should look calm when hearing about pain — this makes the conversation feel safe.
- Summarising what the patient has said shows you have been listening and encourages further disclosure.
- A patient who talks about anger may look very sad and may disclose suicidal feelings when they feel connected enough.
What the consultation-video slides are teaching
| Less productive opening in this case | More productive pivot | Why the patient response changed |
|---|---|---|
| “What's your mood like?” / “Are you sad?” | “Have you been feeling angry or irritable?” | Starts with language the patient recognises rather than requiring him to label sadness |
| “Have you been crying a lot?” | “How are your energy levels?” | A somatic bridge can open discussion without implying that the symptom is imaginary |
| “How has school been?” without follow-up | Ask what changed, when, and how it has affected function | A drop in grades is a clue; the meaning comes from probing it |
| Abruptly asking about drugs/alcohol | Signpost and normalise: “I ask everyone this because it can affect mood and sleep…” | Explains the purpose of a sensitive question and reduces perceived judgement |
| Rapid checklist questioning | Summarise, remain calm, then ask an open follow-up | Demonstrates listening and creates enough safety for disclosure |
The final video-analysis slide shows the sequence connection → elaboration → disclosure: after the clinician summarises and tolerates the patient's distress calmly, “How long have you felt this way?” elicits the patient's own words and eventually suicidal thoughts. This is not a claim that all men present alike; it is a reminder to adapt language to the individual in front of you.
High Yield: Always Assess for Suicide
The slide reports that 45% of people who died by suicide had consulted a GP within the preceding month. [1]
It also stresses that people surviving a near-lethal attempt can have similar clinical and psychosocial profiles to people who died by suicide, and that over half of those who died had first presented with self-harm. [1]
Therefore, ask directly about suicidal thoughts and self-harm whenever depression is suspected. [1,11]
Why is this such a big deal for primary care? Because:
- The GP is often the last medical professional to see the patient alive.
- Previous self-harm is an important marker of future risk.
- Asking about suicide does NOT increase risk — this is a myth. In fact, patients often feel relieved when asked.
How to ask (practical approach):
- Start with hopelessness: "Have you felt hopeless about the future?"
- Escalate: "Have you wished you were dead or that you could go to sleep and not wake up?"
- Be direct: "Have you thought about hurting yourself or ending your life?"
- If yes: explore current intent, plan/preparation, access to means, past attempts/self-harm, intoxication, agitation/psychosis, recent stressors, supports and reasons for living.
PHQ-9 Item 9 directly screens for this: "Thinking that you would be better off dead or that you want to hurt yourself in some way." Any score above 0 warrants further exploration regardless of total score. Conversely, a score of 0 does not replace direct questioning when clinical concern remains.
Safety-first response
Do not turn this into a numeric “low/medium/high” prediction exercise. Focus on the person's immediate and longer-term safety needs. If there is considerable immediate risk, arrange urgent specialist/emergency assessment; address access to lethal means collaboratively, involve supports with consent when appropriate, and develop a safety plan. Risk scales must not decide treatment or discharge. [11,13]
8. Special Populations
Depression in the elderly is often misdiagnosed as dementia or psychosis. [1]
- May include odd behaviours such as histrionic behaviours, delusions, disordered thinking — these can mimic psychosis or dementia.
- Assess sleep — often the most reliable entry point.
- Helpful screening questions (from Geriatric Depression Scale concept):
- Are you basically satisfied with your life?
- Do you feel that your life is empty?
- Are you afraid that something bad is going to happen to you?
- Do you feel happy most of the time?
Clinical significance: late-life depression may cause prominent cognitive symptoms and can coexist with a neurocognitive disorder. “Depressive pseudodementia” is an older shorthand, not a diagnosis and not proof that cognitive impairment will fully reverse. History from the patient and an informant, time course, functional change, mental-state/cognitive assessment, medication/medical review and follow-up after treating depression are more reliable than stereotypes such as “I don't know” versus confabulation.
Do not assume all women want to have children. Even the ones who want to have kids can be sad. Includes health professionals! [1]
Be non-judgmental and remember to ask at every visit! [1]
Specific clues to perinatal depression: [1]
- Poor weight gain in pregnancy
- Excessive anxiety/worries about parenting
- Defaulting medical care
- Low self-esteem
Why does this matter? Perinatal depression affects not just the mother but the child's development (attachment, feeding, cognitive development) and the family unit. The Edinburgh Postnatal Depression Scale (EPDS) is a widely used screening tool in this population (mentioned in OG lectures). [7]
1. Emotional symptoms are common but do not necessarily mean that the sufferer has a diagnosable mood disorder. [1]
2. Many mood disorders are short-lived responses to stresses in people's lives such as work stress or bereavement. [1]
3. The cornerstone to the detection of a mood disorder is an understanding of the presenting symptoms and syndromes and exploring sleep, psychosocial history. [1]
4. Depression and anxiety are common in primary care but are missed by doctors in at least 50% of cases. [1]
5. Screening tools such as the PHQ-9 and GAD-7 can be useful to enhance detection rates for depression and anxiety. [1]
6. Patients with depression or anxiety often present with physical symptoms. [1]
10. Integration with Related Material
When a primary care screen is positive, the next step is a proper psychiatric assessment. The psychiatric structured interview includes: [8]
- Presenting complaint (in patient's own words)
- HPI: nature, onset, duration, severity, precipitating/perpetuating factors, functional impact
- Risk assessment (suicide, self-harm, harm to others)
- Mental State Examination (MSE)
- Brief cognitive assessment (if indicated)
MUPS and mental health problems are listed as the top two indications for a family-oriented approach to patient care. [9] Understanding the patient's family context — life-cycle stage, family stressors, social support — is essential for both detection and management.
A 2024 past paper EMQ (Q22-23) tested this directly: a 60-year-old grieving accountant presenting with insomnia — the main reason for consultation was insomnia (not depression), because he needed to function at work (patient's agenda). A 32-year-old mother with insomnia — main reason was limit of anxiety (about dementia). Understanding the patient-centred reason for consultation is key. [10]
This lecture focuses on detection, not treatment selection. A PHQ-9 or GAD-7 band is a symptom-severity measure, not a treatment algorithm. After a positive screen: [11]
- Confirm the clinical syndrome and functional impact; review duration, course and previous episodes.
- Check differentials and contributors, including bipolarity, substances/medicines, physical illness, bereavement/trauma and coexisting disorders.
- Ask directly about suicide/self-harm and formulate immediate safety needs.
- Use shared decision-making to select an intervention according to clinical severity, patient preference, prior response, comorbidity and local pathways—not the questionnaire total alone.
- Arrange follow-up and use the same validated measure, where helpful, to track response.
| Feature | PHQ-2 | PHQ-9 | GAD-7 |
|---|---|---|---|
| Purpose | Quick depression screen | Depression screening + severity + monitoring | GAD screening + severity |
| Items | 2 | 9 | 7 |
| Timeframe | Past 2 weeks | Past 2 weeks | Past 2 weeks |
| Score range | 0–6 | 0–27 | 0–21 |
| Positive cut-off | ≥ 3 | ≥ 10 | ≥ 10 |
| Sensitivity / Specificity | 84% / 90% | 88% / 88% | 89% / 82% |
| Based on | 2 core symptom domains | 9 DSM-5 symptom domains | DSM-5 GAD symptom domains |
| Diagnostic? | No — screening only | No — screening only | No — screening only |
| Can monitor treatment? | No | Yes | Yes |
| Age | Adults | ≥ 12 years | Adults |
| Other uses | — | — | Can screen for other anxiety disorders |
| Feature | MDD | GAD |
|---|---|---|
| Duration requirement | ≥ 2 weeks | ≥ 6 months |
| Number of symptoms required | ≥ 5 of 9 | ≥ 3 of 6 (plus excessive worry) |
| Cardinal symptom | Low mood AND/OR anhedonia | Excessive uncontrollable worry |
| Weight/appetite change | Yes (DSM criterion) | Not a criterion |
| Muscle tension | Not a criterion | Yes (DSM criterion) |
| Suicidal ideation | Yes (DSM criterion) | Not a criterion |
| Worthlessness/guilt | Yes (DSM criterion) | Not a criterion |
| Overlapping symptoms | Sleep, concentration, fatigue, irritability | Sleep, concentration, fatigue, irritability |
| Screening tool | PHQ-9 | GAD-7 |
High Yield Summary
- Depression and anxiety are often missed in primary care because distress may be expressed through sleep, fatigue, pain or other bodily symptoms rather than mood labels.
- PHQ-2 ≥3, PHQ-9 ≥10 and GAD-7 ≥10 are useful screening/severity thresholds, not diagnoses or automatic treatment rules.
- DSM-5 MDD: at least 5 symptoms during the same 2-week period, including low mood and/or anhedonia, with clinically significant distress or impairment and appropriate exclusions.
- DSM-5 GAD: excessive, difficult-to-control worry more days than not for at least 6 months, plus at least 3 associated symptoms in adults and significant distress/impairment.
- The lecture reports MUPS in about 18.5% of primary-care consultations. Ask about sleep as a non-stigmatising bridge, while continuing appropriate physical assessment.
- Always ask directly about suicide and self-harm when depression is suspected. Assess needs and immediate safety; do not rely on a questionnaire item or numeric risk category.
- Adapt language to the individual: irritability, functional decline or somatic concerns may open the conversation when “Are you depressed?” does not.
- In older adults, depression and cognitive disorder can mimic or coexist with each other; in the perinatal period, ask non-judgmentally and repeatedly rather than assuming happiness about pregnancy/parenthood.
Active Recall - Common Mental Health Problems in Primary Care
[1] Lecture slides: GC 017. Common mental health problems in primary care.pdf (all pages) [2] Senior notes: Ryan Ho Psychiatry.pdf (pp. 158, 204, 70) [3] Past papers: 2022 Fourth Summative MCQ.pdf (Q80) [4] Past papers: 2023 Fourth Summative MCQ.pdf (Q75) [5] Past papers: 2025 Fourth Summative MCQ.pdf (Q19) [7] Lecture slides: CFB (OG02) Puerperium and Related Problems.pdf [8] Lecture slides: General Clerkship-Psychiatric Assessment Skills Training-Learning Materials 2024_3 Sep.pdf (pp. 2, 28) [9] Lecture slides: GC 019. The Family in Family Medicine [Pre-Lecture Reading 1].pdf (p. 2) [10] Past papers: 2024 Fourth Summative MCQ.pdf (Q22-23) [11] National Institute for Health and Care Excellence. Depression in adults: treatment and management (NG222). 2022; recommendations on recognition, comprehensive assessment and direct assessment of suicidal ideation/intent. [12] National Heart, Lung, and Blood Institute. Insomnia: Diagnosis. Chronic insomnia definition and sleep-diary assessment. Updated 2022. [13] National Institute for Health and Care Excellence. Self-harm: assessment, management and preventing recurrence (NG225). 2022; needs-based safety assessment, safety planning and limits of risk scales.
GC016 Radiology Of Common Medical And Surgical Problems
Radiology of common medical and surgical problems encompasses the use of imaging modalities such as X-ray, ultrasound, CT, and MRI to diagnose, evaluate, and guide management of frequently encountered clinical conditions across medical and surgical disciplines.
GC018 Health Promotion And Disease Prevention In Primary Care
Health promotion and disease prevention in primary care encompasses the systematic application of screening, immunization, counseling, and lifestyle modification strategies to maintain wellness and reduce the incidence and progression of disease at the individual and community level.