Jun 27, 2021
Written By: Dr. Vishalini Sivarajah
Expert Review By: Dr. Darby Ewashina
https://thegenerehlist.ca/ccfp-exam-105-topics-podcast/
Objective One:
In a patient with a diagnosis of depression: Assess the patient for
the risk of suicide. Decide on appropriate management (i.e.,
hospitalization or close follow-up, which will depend, for example,
on severity of symptoms, psychotic features, and suicide risk)
Objective Two:
Identify patients who may be at a higher risk for depression (e.g.,
certain socio-economic groups, those who suffer from substance
abuse, postpartum women, people with chronic pain) and assess
appropriately.
Objective Three:
In patients who have medically unexplained symptoms consider and
assess for depression.
Objective Four:
After a diagnosis of depression is made look for and diagnose other
comorbid psychiatric conditions (e.g., anxiety, bipolar disorder,
personality disorder).
Objective Five:
In a patient diagnosed with depression: Manage appropriately (e.g.,
medications, psychotherapy, supported self-management) Monitor
their response to therapy and modify appropriately (e.g.,
augmentation, dose changes, medication changes), Reassess the
patient’s safety, Set goals, including a return-to-work plan, Refer
as necessary (including community resources)
Objective Six:
In a patient presenting with symptoms consistent with depression
consider and rule out serious organic pathology using a targeted
history, physical examination, and investigations (especially in
elderly or difficult patients).
Objective Seven:
In patients presenting with depression inquire about abuse:
Objective Eight:
In a patient with symptoms of depression differentiate major
depression from adjustment disorder, dysthymia, and a grief
reaction.
Objective Nine:
Following failure of an appropriate treatment in a patient with
depression consider other diagnoses (e.g., bipolar disorder,
schizoaffective disorder, organic disease).
Objective Ten:
In very young and elderly patients presenting with changes in
behaviour consider the diagnosis of depression (as they may not
present with classic features).
Objective Eleven:
When treating a patient with antidepressants use them in a
selective and careful manner, adapted to the presentation and the
needs of the individual patient, by: Selecting the most appropriate
antidepressant and dose for the patient based on patient factors
and on pharmacological factors (e.g., possible drug interactions),
Monitoring medication effectiveness, including adherence and the
patient’s possible self-medication using other substances (e.g.,
herbal and naturopathic remedies, alcohol, cannabis), Considering
augmentation strategies when appropriate, Monitoring side effects
carefully when initiating treatment, especially in young and
elderly patients,
Objective Twelve:
When developing a return-to-work plan for a patient who is being
treated for depression: Assess the impact of residual symptoms on
work hardiness, performance, and safety & Communicate with the
patient and the workplace to ensure the plan is realistic and
provides clear guidance