Mental health

CPD | Post-traumatic stress disorder (PTSD)

This is an updated guideline from NICE on Post-Traumatic Stress Disorder PTSD. The last guideline came out in 2005. I don't think this really changes our management much (i.e. watch and wait for 1 month and then refer for most patients), but I will summarise the symptoms we should be looking out for and also…
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CPD | Management of dementia

This is a new guideline from NICE on the management of dementia. Most of this is not new, but there were a couple of things I wasn't fully aware of. I'll list the things that were new to me, then do a bit of a summary. Cognitive testing. NICE lists a few recommended tests we…
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Eating Disorders

This is a new guideline from NICE on managing eating disorders. It is really targeted around anorexia nervosa and bulimia. Much of this is not new, but as we don't see patients with these disorders too often, I'll do a general summary, but concentrating on things I wasn't aware of. Presentation This is not an…
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Nice | Nalmefene for reducing alcohol consumption

This is a guideline on Nalmefene from NICE; they originally advised that Nalmefene could be used in Nov 14. This lays out how. It is an opioid receptor modulator and can help to reduce alcohol consumption in people with alcohol dependence. People should: be drinking at a 'high drinking risk level' (7.5 units a day…
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Nice | Vortioxetine in major depression

This is a new guideline from NICE advising that vortioxetine can be used in major depression, when 2 other medications have already been used in the same episode. It is thought to directly modulate receptors and also to inhibit serotonin uptake. Louise HudmanI’m a freelance GP locum in Winchester & Southampton. NEW! – Use the…
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Nice | Challenging behaviour and learning disabilities

This is a new guideline from Nice on managing challenging behaviour in people with learning disabilities. Most of it is fairy obvious. I've highlighted a few points. Behaviours may be to communicate, to provide sensory stimulation, to avoid demands or to attract attention. Consider the patient's environment, relationships and medications among other things. Look for…
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Nice | Depression in children and young people

This is an updated guideline from Nice on managing depression in children. Most of the advice is the same and the changes really just follow normal practice. I've highlighted the changes below. Assessment (no change here) Consider using the Mood and Feelings Questionnaire. A score of 12 or more supports a diagnosis of depression. Mild…
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Nice | Antenatal and postnatal mental health

This is an updated guideline from Nice on antenatal and postnatal mental health. There really isn't anything earth shattering in this - most of it we would do anyway. I have highlighted some key points that I hadn't necessarily appreciated. This is not an exhaustive summary, just the things that were new for me. General guidance…
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Nice | Bipolar disorder

This is a an updated guideline from NICE on Bipolar Disorder. I don't think there is much new in this, but it does clarify what we should be doing at annual reviews, general health checks we should be doing and clarifies a definition of 'mania' and 'hypomania'. Definitions Mania – abnormally elevated mood or irritability and related…
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