Mind Matters

After charanya and dom left (Mr. 8.30 and yingx left early for some conference) the emergency department, i was left alone to survive the boredom till 5pm. Thats when the driver arrives and when i can go home.

For those who don't know me well:
(i) i can drive just not licensed to do so (yet)
(ii) i refuse to pay extra for cab. the fares rise faster than flour

So yea as i battled the sheer mind-numbing inaction (not a single P1 patient) busying myself going through random X rays, Lab reports and attempting to take a decent history and physical examination from any willing patients (most are nice), this lady got wheeled in from the p3 area.

Middle aged Chinese lady with a history of depression, lets call her Miss X. I know patient confidentiality is very important and i wholly agree. As such, her background will only be mentioned briefly:
- lives with her bf and 2 children
- bf's a drug addict
- she gives tuition to 'get by'

Anyway I didn't spot her at first (was busy finding that elusive vein in this very cachetic but very friendly elderly lady) until a police officer from clementi station asked me if i knew a patient by the name of Miss X who came in for valium overdose. Faced with such a challenging question, and to hide my lack of familiarity with the patients currently in P2, i played the 'bail' card:

"sorry sir, i'm a medical student". HAHA always works.

So lets now discuss: Depression and Mania (dont worry i won't throw the GSMIV at you)

SAGE + CAPS + L (12 in all)
- Sleep disturbances
- Anhedonia
- Guilt
- Energy levels low
- Cognitive loss, Concentration loss
- Appetite loss, asocial (social withdrawal)
- Psychomotor retardation
- Suicidal, somatic complaints
- Low Mood
"Think of a Robot (doesnt need to eat, doesnt need to sleep, can't enjoy things) which malfunction (poor performance status)"

MANIA: DIG + FAST (9 in all)
- Distractibility
- Indiscretion, irritable
- Grandiosity
- Flight of ideas, familiarity
- Activity
- Sleep
- Talkative (Pressure of speech)

Quick Assessment of Suicide Risks: SAD PERSONS SCORE, a 10 item assessment scale
- Sex (male)
- Age (<19>45)
- Depression or hopelessness (SAGE + CAPS + L)
- Previous attempt or psychiatric care
- Excess alcohol or drug abuse
- rational thinking loss: psychosis, organic brain disease
- Separated, divorced, widowed
- Organized plan/serious attempt
- No social support
- Sickness, chronic disease

<6: low risk
6-8: moderate risk
9-10: high risk!