SIGECAPS - Mnemonics for Major Depressive Disorder

Another mnemonics. This time it's for symptoms of major depression and dysthymia.

S - Sleep disorder* (insomnia or hypersomnia)
I - Interest deficits (anhedonia)
G - Guilt (worthlessness*, hopelessness*, regrets)
E - Energy (lack of energy)*
C - Concentration deficit*
A - Appetite reduced*
P - Psychomotor retardation or agitation
S - Suicidality - (to assess suicidal risk, use SAD PERSONS scale).

NOTE: To meet the diagnosis of major depression, a patient must have four of the symptoms plus depressed mood or anhedonia, for at least two weeks. To meet the diagnosis of dysthymic disorder, a patient must have two of the six symptoms marked with an asterisk, plus depression, for at least two years.

Reference: American Academy of Family Physicians (AAFP)

Schneider First Rank Symptoms

This is the mnemonics of Schneider's first rank symptoms. Presence of these symptoms proves the likelihood of schizophrenia (but bear in mind that it is not diagnostic for schizophrenia).

A - Auditory hallucinations (third person, running commentary)
B - Broadcasting of thoughts (thought broadcasting)
C - Controlled thought (delusions of control)
D - Delusional perception.

and thought insertion, thought withdrawal

Possible OSCE question for Psychiatry; apart from SAD PERSONS, mental state examination, or mini ental state examination.

Quick Revision 5 - Agoraphobia (Short Note)

Short Note (25 Marks)


What is agoraphobia? How do you treat patient with agoraphobia?

Agoraphobia is the fear of being in public places. It can be diagnosed alone or as panic disorder with agoraphobia; 50 - 75% of patients have coexisting panic disorder. It occur more in female than male. Symptoms include palpitations, shortness of breath, and sweating when being exposed to such condition.

DSM IV criteria

• Anxiety about being in places or situations from which escape might be difficult, or in which help would not be readily available in the event of a panic attack
• The situations are either avoided, endured with severe distress, or paced only with the presence of a companion.
• These symptoms cannot be better explained by another mental disorder

Management of patient with agoraphobia involves psychoanalytic therapy. He will be attended by a psychiatrist which will guide him to tell about his past since childhood days until recently. He will be seated on a comfortable chair and faced away from the psychiatrist. The psychiatrist will listen to his story and made an analysis from it.

Patient will also undergo desensitization by gradually exposing him to face the situation. Prior to that, patient will be taught of relaxation technique and was given ample time to practice before being exposed to the situation.

Pharmacotherapy : Since agoraphobia is usually associated with panic disorder, selective serotonin receptor inhibitors (SSRIs) such as sertraline, are also considered as the first-line treatment.

When agoraphobia is not associated with panic disorder, it is usually chronic and debilitating.

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Does this enough for 25 mark-question?! I don't think so... What else should I include or further elaborate?