Mood ulsorders Self Parm

Sulclde
sychlaLry
Wednesday CenLral 1eachlng
1
earnlng Cb[ecLlves
knowledge
SympLoms of depresslon lncludlng somaLlc syndrome
and psychoLlc depresslon
SympLoms of manla
Pow Lo classlfy depresslon and blpolar dlsorder
8lopsychosoclal managemenL of depresslon and
blpolar dlsorder
8aslcs of aeLlology and prognosls
nlCL guldance
lndlcaLlons of LC1
lLhlum LoxlclLy and problems wlLh mood sLablllsers
and pregnancy
2
earnlng Cb[ecLlves
knowledge
ueflnlng Lhe concepLs of sulclde and
dellberaLe self harm
Lpldemlology and posslble aeLlologlcal facLors
of sulclde and self harm
undersLandlng Lhe relaLlonshlp beLween
sychlaLrlc lllness and Sulclde of uellberaLe
Self Parm
3
earnlng Cb[ecLlves
Skllls
lnLervlew a depressed paLlenL and ellclL depresslve
sympLoms
Lxplaln Lo a paLlenL abouL causes LreaLmenL and
prognosls of depresslon and blpolar dlsorder
Make a dlagnosls of a mood dlsorder
lormulaLe a blopsychosoclal managemenL plan for a
paLlenL wlLh depresslon and blpolar dlsorder
Assess Lhe rlsk and manage a sulcldal paLlenL
4
earnlng Cb[ecLlves
ALLlLudes
8especLful Lowards paLlenLs wlLh depresslon
or blpolar dlsorder
LmpaLhy Lo a sulcldal paLlenL
3
uepresslon
6
1lme for a qulz!
7
Which of the following is % the core symptoms
of depression?

1 uepressed mood
2 ulsLurbed sleep
3 Anhedonla
4 8educed energy
1lme for a qulz!
8
Which of the following is % , som,tic symptoms
of depression?

1 Anhedonla
2 ulurnal varlaLlon ln mood
3 sychomoLor reLardaLlon /aglLaLlon
4 8educed energy
3 Larly mornlng wakenlng
SympLoms of uepresslon
Core sympLoms
ow mood
oss of lnLeresL +
en[oymenL (Anhedonla)
8educed energy
CLher common sympLoms
8educed concenLraLlon
8educed selfesLeem +
confldence
ldeas of gullL + unworLhlness
esslmlsm re fuLure
ldeas / acLs of selfharm /
sulclde
ulsLurbed sleep
8educed appeLlLe
9
Atypical depression - sleep and eat more
Psychotic depression
sychoLlc uepresslon
ueluslons
O Mood congruenL
O WorLhlessness/gullL/lll healLh/poverLy/lmmlnenL
dlsasLer
O nlhlllsLlc deluslons (CoLards syndrome)
O May have persecuLory deluslons
PalluclnaLlons
O 2nd person audlLory defamaLory/accusaLory
O ClfacLory fllLh/roLLlng/decomposlng flesh
10
sychoLlc uepresslon vldeo
11
SomaLlc sympLoms of
depresslon
need aL leasL 4 of Lhe followlng sympLoms Lo
dlagnose somaLlc syndrome
O markedly reduced appeLlLe
O welghL loss (3+ of normal body welghL ln 1 monLh)
O early mornlng wakenlng (aL leasL 2hrs before usual Llme)
O dlurnal varlaLlon ln mood
O psychomoLor reLardaLlon/aglLaLlon
O loss of llbldo
O Anhedonla
O lack of emoLlonal reacLlvlLy
12
lCu10 classlflcaLlon of depresslve
eplsode
O Mlld
wlLh/wlLhouL somaLlc syndrome
O ModeraLe
wlLh/wlLhouL somaLlc syndrome
O Severe
wlLh/wlLhouL psychoLlc sympLoms
Also
O recurrenL depresslve dlsorder currenL eplsode (one
of Lhe above)
1lme for a qulz!
14
Which of the following is % %#& reg,rding
epidemiology of depression?

1 lfeLlme prevalence of ma[or depresslon ls 3

2 uepresslon ls more common ln woman
3 MosL paLlenLs wlLh depresslon see a psychlaLrlsL
4 Average age of onseL for depresslon ls abouL 27
Lpldemlology of depresslon
lfeLlme prevalence of depresslve
sympLoms 20
lfeLlme prevalence of ma[or depresslon 3
MosL depresslon LreaLed ln prlmary care
(Cnly 01 admlLLed Lo hosplLal around
10 are referred Lo a psychlaLrlsL)
13
16
Small group dlscusslons
(groups of 3)
Why ls depresslon noL recognlsed?
Pow can depresslon be beLLer recognlsed?
lallure Lo recognlse
depresslon
aLlenL no polnL ln Lalklng abouL lL"
SLlgma
lear of anLldepressanL medlcaLlon
SomaLlc presenLaLlon
Comorbld dlsorders
CompllcaLed grlef
17
lallure Lo recognlse
depresslon
ulagnosls raLe 3 Llmes hlgher when Lhere ls an
obvlous psychologlcal lssue ln Lhe narraLlve
key lssue
noL lack of knowledge abouL depresslon buL
communlcaLlon skllls
18
Pow Lo lmprove dlagnosLlc
raLe?
More Llme!
lmproved communlcaLlon skllls
8eLLer eye conLacL
Cpen ended quesLlons
8eaLLrlbuLe physlcal sympLoms Lo psychologlcal
causes
'Are you under unusual or exLra sLress?'
'uo you Lhlnk Lhese sympLoms may be due Lo
sLress?'
19
vldeo MSL Mood
20
8ole lay vlgneLLe 1
21
1lme for a qulz!
22
Which of the following is % %#& reg,rding
,etiology of depression?

1 uopamlne hypoLhesls ls one of Lhe blologlcal Lheorles for

depresslon
2 CognlLlve Lheory of depresslon focuses on negaLlve
auLomaLlc LhoughLs such as overgenerallsaLlon
3 oor soclal supporL and lack of lnLlmacy are lmporLanL
soclal facLors ln aeLlology of depresslon
4 1here ls a 6fold lncrease of loss or negaLlve llfe evenLs ln
Lhe monLh before Lhe onseL of depresslon
AeLlologlcal facLors
8lologlcal
CeneLlcs
Monoamlne hypoLhesls
sychologlcal
CognlLlve Lheorles errors of Lhlnklng
psychoanalyLlc Lheorles loss of loved ob[ecL or
fallure Lo pass Lhrough depresslve poslLlon
learned helplessness
23
AeLlologlcal facLors
Soclal facLors
ack of lnLlmacy
oor soclal supporL
lfe evenLs
excess of llfe evenLs esp losses
ersonallLy
ow selfesLeem
erfecLlonlsm
24
rognosls of depresslon
3060 recover wlLhln a year
Chronlc depresslon (more Lhan 2 yrs) occurs ln
1023
8ecurrence
1 year laLer 23 wlll have had anoLher eplsode
10 yrs laLer 73 wlll have had anoLher eplsode
ChronlclLy of sympLoms relaLed Lo prognosls
23
ulfferenLlal ulagnosls for
depresslon
Ad[usLmenL dlsorder
Crganlc syndromes
Secondary Lo anxleLy dlsorders
CCu
1Su
SomaLlsaLlon
SubsLance mlsuse (lncludlng alcohol)
uysLhymla
26
Mlxed AnxleLy uepresslve
ulsorder
MlxLure of anxleLy and depresslve sympLoms
wlLhouL clear promlnence of any one Lype
resenL for more Lhan 6 monLhs
27
uysLhymlc ulsorder
uepressed mood 2 years (ofLen much longer)
1wo or more of
oor appeLlLe or overeaLlng
lnsomnla or hypersomnla
ow energy or faLlgue
ow selfesLeem
oor concenLraLlon or dlfflculLy maklng declslons
leellngs of hopelessness
no ma[or depresslve eplsode durlng flrsL Lwo years of lllness
uepresslve eplsodes may be superlmposed (double
depresslon)
28
Ad[usLmenL ulsorder wlLh
depressed mood
8eacLlon Lo sLressful evenL or slLuaLlon usually lasLlng
less Lhan 6 monLhs
CnseL usually wlLhln 3 monLhs of onseL of sLressor
SlgnlflcanL lmpalrmenL ln soclal occupaLlonal or
educaLlonal funcLlonlng
1he sympLoms are noL caused by bereavemenL
Cnce Lhe sLressor (or lLs consequences) has
LermlnaLed Lhe sympLoms do noL perslsL for more
Lhan an addlLlonal 6 monLhs
29
8lpolar ulsorder
30
1lme for a qulz!
31
Which of the following is % %#& reg,rding
bipol,r disorder?

1 lf a paLlenL has had Lwo or more affecLlve eplsodes lncludlng aL

leasL one of hypomanla or manla Lhey suffer from blpolar dlsorder
2 Cne of Lhe feaLures ln hypomanla ls grandlose deluslon and
audlLory halluclnaLlon
3 lncldence for blpolar dlsorder ls Lhe same for men and women and
lL ls abouL 1
4 1he average age of onseL for blpolar dlsorder ls lower Lhan LhaL for
depresslon
Manla/Pypomanla
764.5. .5.
Nild elevation of mood or irritable Elevated, Expansive or !rritable
!ncreased energy !ncreased activity
Nild overspending or risk taking Reckless behaviour
Sociability or Overfamiliarity Disinhibition
Talkativeness Pressure of speech
Distractible Distractible or constant changes
!ncreased sexual energy Narked increased sexual energy
Decreased need for sleep Decreased need for sleep
Crandiosity
Flight of ideas
32
Manla wlLh psychoLlc sympLoms
CrlLerla for manlc eplsode meL wlLh Lhe addlLlon
of psychoLlc sympLoms
ueluslons
CfLen mood congruenL
lnflaLed selfesLeem and ldeaLlon may develop lnLo
fully formed grandlose deluslons
lrrlLablllLy and susplclousness may become deluslons
of persecuLlon
PalluclnaLlons
ess frequenL
Mood congruenL
Second person audlLory
33
vldeo Manla
34
8lpolar affecLlve dlsorder
lf a paLlenL has had a prevlous or subsequenL
affecLlve eplsode (depresslve manlc or
hypomanlc) Lhey fulfll Lhe crlLerla for a bipo/or
offective disorder
33
Lpldemlology of blpolar
dlsorder
lfeLlme rlsk 1
Ml
Average age onseL 21yrs
SLrong geneLlc herlLablllLy llfeLlme rlsk ln
1sL degree relaLlves 10
Also lncreased famlllal rlsk of unlpolar
depresslon and schlzoaffecLlve dlsorder
36
1lme for a qulz!
37
Which of the following is % %#& reg,rding
bipol,r disorder?

1 90 of paLlenLs wlLh manlc eplsode wlll have

repeaL eplsodes
2 aLlenLs wlLh blpolar dlsorder usually have more
manlc eplsodes Lhan depresslve eplsodes
3 SLerold ls one of Lhe posslble causes of manlc
sympLoms
4 AnLldepressanLs can Lrlgger a manlc eplsode ln
paLlenL wlLh blpolar dlsorder
rognosls of 8lpolar
ulsorder
Chronlc lllness eplsodlc wlLh only 1/3 havlng
some resldual sympLoms beLween eplsodes
1yplcally 810 manlc/depresslve eplsodes over
llfeLlme ln unLreaLed cases
90 of Lhose wlLh manlc eplsode wlll have repeaL
eplsodes
uepresslve eplsodes manlc eplsodes
no cure buL wlLh LreaLmenL boLh lnLenslLy and
frequency of eplsodes reduce
38
ulfferenLlal dlagnosls
CycloLhymlc ulsorder
Crganlc mood dlsorder
SchlzoaffecLlve dlsorder
39
CycloLhymlc ulsorder
numerous perlods wlLh depresslve sympLoms
alLernaLlng wlLh hypomanlc sympLoms over a
perlod 2 years ofLen longer
none of Lhe lndlvldual eplsodes meeL Lhe
crlLerla for blpolar dlsorder or ma[or
depresslon
no ma[or depresslve or manlc eplsode durlng
flrsL Lwo years of lllness
noL explalned by drugs or medlcal lllness
40
Crganlc mood dlsorders
Lndocrlne hyperLhyroldlsm Cushlngs
lnfecLlve lnfecLlous mononucleosls
neurologlcal (fronLal lobe) CvA Lumours
epllepsy
urugs sLerolds
SubsLance lnduced eg ampheLamlne
41
SchlzoaffecLlve dlsorder
CrlLerla of schlzophrenla and an affecLlve
dlsorder are meL
1he Lwo componenLs commenced aL Lhe same
Llme or wlLhln few days
8oLh componenLs are of equal lmporLance
Can be caLegorlse lnLo
manlc Lype
depresslve Lype
42
Sulclde and uellberaLe Self Parm
43
1lme for a qulz!
44
Which of the following is % %#& reg,rding
suicide?

1 100 of sulcldes have some form of psychlaLrlc

lllness
2 1013 of paLlenLs wlLh depresslon commlL
sulclde
3 aLlenLs wlLh hlgher premorbld funcLlonlng ln
schlzophrenla are more llkely Lo klll Lhemselves
4 Alcohollsm has been shown Lo lncrease rlsk of
sulclde
Ceneral rlsk facLors for sulclde
Ml
peaks for young men and older men
unemployed
wldowed / dlvorced
hyslcal lllness
rlsoners
Alcohol abuse
ersonallLy dlsorder
asL hlsLory of dellberaLe self harm (30 sulcldes have
h/o uSP)
43
Sulclde and menLal lllness
uepresslon (1013 of depressed paLlenLs klll
Lhemselves)
Schlzophrenla (410)
Alcohollsm (13 laLe ln Lhelr lllness)
neuroLlc dlsorders panlc dlsorder 1Su
ersonallLy dlsorder especlally borderllne or
anLlsoclal personallLy dlsorders
46
1lme for a qulz!
47
Which of the following is % %#& reg,rding
deliber,te self h,rm (DSH)?

1 uSP ls commonesL among female aged 13 Lo 34

years
2 ersonallLy dlsorder ls one of Lhe predlcLors of
repeaLlng uSP
3 40 of paLlenLs wlLh uSP wlll ulLlmaLely commlL
sulclde
4 recauLlons Lo avold lnLervenLlon or dlscovery
lndlcaLes sulcldal lnLenL ln uSP
uellberaLe Self Parm (uSP)
ueflnlLlon
uellberaLe nonfaLal acL wheLher physlcal drug
overdoes or polsonlng done ln Lhe knowledge LhaL
lL was poLenLlally harmful and ln case of drug
overdose LhaL Lhe amounL Laken was excesslve
Lpldemlology
lM 21
ulvorcedslnglewldowedmarrled
2/3 of paLlenLs under 33 of age
48
uellberaLe Self Parm (uSP)
redlcLors of repeLlLlon of uSP
number of prevlous eplsodes
ersonallLy dlsorder
PlsLory of vlolence
Alcohollsm
unmarrled
ower soclal class
49
uellberaLe Self Parm (uSP)
lacLors lndlcaLlng sulcldal lnLenL ln uSP
lsolaLlon
1lmlng
recauLlons Lo avold lnLervenLlon
Sulclde noLe
AnLlclpaLory acLs (eg wlll)
vlolenL meLhods
percelved" leLhallLy
30
31
Small group dlscusslons
(groups of 3)
CuesLlons Lo ask Lo assess sulclde rlsk?
Assesslng sulclde aLLempLs
1hlngs Lo ask abouL lnclude
lannlng
lnLenL
ALLempLs Lo avold dlscovery
MeLhod used
LxpecLaLlon of ouLcome
Sulclde noLe / flnal acLs
revlous aLLempLs
lnLoxlcaLlon
32
8ole lay vlgneLLe 2
33
arLlclpanL Scores
34
4 arLlclpanL 1
4 arLlclpanL 19
4 arLlclpanL 27
4 arLlclpanL 29
3 arLlclpanL 6
3 arLlclpanL 30
2 arLlclpanL 3
2 arLlclpanL 7
2 arLlclpanL 8
2 arLlclpanL 9
unch 8reak
33
1o recap
36
8raln Lxerclse dlfferenLlal
dlagnosls (vlgneLLe 3a)
37
1
1
1
1
1
1
1
1 1 Crganlc mood dlsorder
2 8lpolar ulsorder currenLly manlc
3 uysLhymla
4 CycloLhymla
3 SchlzoaffecLlve ulsorder
6 Mlxed anxleLy depresslve dlsorder
7 Ad[usLmenL ulsorder
8 uepresslve eplsode
8raln Lxerclse dlfferenLlal
dlagnosls (vlgneLLe 3b)
38
1
1
1
1
1
1
1
1 1 Crganlc mood dlsorder
2 8lpolar ulsorder currenLly manlc
3 uysLhymla
4 CycloLhymla
3 SchlzoaffecLlve ulsorder
6 Mlxed anxleLy depresslve dlsorder
7 Ad[usLmenL ulsorder
8 uepresslve eplsode
8raln Lxerclse dlfferenLlal
dlagnosls (vlgneLLe 3c)
39
1
1
1
1
1
1
1
1 1 Crganlc mood dlsorder
2 8lpolar ulsorder currenLly manlc
3 uysLhymla
4 CycloLhymla
3 SchlzoaffecLlve ulsorder
6 Mlxed anxleLy depresslve dlsorder
7 Ad[usLmenL ulsorder
8 uepresslve eplsode
8raln Lxerclse dlfferenLlal
dlagnosls (vlgneLLe 3d)
60
1
1
1
1
1
1
1
1 1 Crganlc mood dlsorder
2 8lpolar ulsorder currenLly manlc
3 uysLhymla
4 CycloLhymla
3 SchlzoaffecLlve ulsorder
6 Mlxed anxleLy depresslve dlsorder
7 Ad[usLmenL ulsorder
8 uepresslve eplsode
8raln Lxerclse dlfferenLlal
dlagnosls (vlgneLLe 3e)
61
1
1
1
1
1
1
1
1 1 Crganlc mood dlsorder
2 8lpolar ulsorder currenLly manlc
3 uysLhymla
4 CycloLhymla
3 SchlzoaffecLlve ulsorder
6 Mlxed anxleLy depresslve dlsorder
7 Ad[usLmenL ulsorder
8 uepresslve eplsode
ManagemenL of mood dlsorders
62
Croup resenLaLlon
Draft a management p|an for
1 A depresslve eplsode ln depresslve dlsorder
2 AcuLe manlc eplsode ln blpolar dlsorder
3 AcuLe depresslve eplsode ln blpolar dlsorder
4 ong Lerm managemenL ln a paLlenL wlLh recurrenL affecLlve
eplsodes ln blpolar dlsorder
63
Cons|der
8lopsychosoclal managemenL plan
SeLLlngs (lnpaLlenL vs communlLy vs homeLreaLmenL)
CLher lmporLanL lssues (eg rlsk mulLldlsclpllnary approach
Care rogramme Approach long Lerm effecLs eLc)
uepresslve eplsode ln depresslve
dlsorder
64
63
8lologlcal managemenL of
depresslon
rlmary Care
SS8l
MlrLazeplne
Moclobemlde (8lMA)
1CA (noL dosulepln)
8eboxeLlne (nA8l)
Mlanserln
1razodone
Secondary Care
venlafaxlne
uosulepln
henelzlne (MACl)
ComblnaLlon
anLldepressanLs eg
SS8l+mlrLazeplne
AugmenLaLlon wlLh
lLhlum
LC1
66
LlecLroconvulslve Lherapy
LC1
nlCL recommends for
Severe depresslon
CaLaLonla
Severe / prolonged manla
Some dlsagree wlLh nlCL llmlLaLlons
67
nlCL guldellnes for
depresslon
SLepped care maLch needs of paLlenL Lo Lhe
lnLervenLlonhlgher sLep for more complex cases
Mlld depresslon
avold medlcaLlon Lry selfhelp psychologlcal
lnLervenLlons soclal supporL
lor moderaLe / severe depresslon
medlcaLlon usually SS8l or C81 or a comblnaLlon
1ake medlcaLlon for 6 monLhs beyond recovery
lor recurrenL depresslon Lake medlcaLlon for 2 yrs
sychologlcal managemenL
Self help groups llLeraLure
Counselllng
roblemsolvlng Lherapy
CognlLlve behavloural Lherapy (selfhelp
compuLerlsed or wlLh LheraplsL)
lnLerpersonal Lherapy
explore personal losses role dlspuLes poor soclal skllls
sychodynamlc psychoLherapy
lndlvldual/group
Soclal managemenL
CccupaLlonal Lherapy
uay hosplLal
Pouslng
LmploymenL/ beneflLs
Pomehelp
Soclal skllls Lralnlng
Carers assessmenL/groups
Lxerclse may be useful for mlld depresslon
WhaL ls your oplnlon of Lhe
presenLaLlon?
70
%he present,tion is comprehensive ,nd e,sy to follow.

1 SLrongly Agree
2 Agree
3 ulsagree
4 SLrongly ulsagree
AcuLe manlc eplsode ln blpolar
dlsorder
71
8lologlcal LreaLmenL of
acuLe manlc eplsode
Clanzaplne (oral or lM)
8lsperldone
CueLlaplne
Paloperldol (oral or lM)
lLhlum
Semlsodlum valproaLe
Carbamazeplne
8enzodlazeplnes
72
sychosoclal managemenL
of acuLe manla
easL sLlmulaLlng mosL supporLlve
envlronmenL
llnance
8elaLlonshlp
73
WhaL ls your oplnlon of Lhe
presenLaLlon?
74
%he present,tion is comprehensive ,nd e,sy to follow.

1 SLrongly Agree
2 Agree
3 ulsagree
4 SLrongly ulsagree
AcuLe depresslve eplsode ln
blpolar dlsorder
73
1reaLmenL of blpolar
depresslve eplsode
kecoqoltloo of depresslve eplsode ls lmporLanL
Avold rouLlne use of anLldepressanLs
CpLlmlse prophylacLlc LreaLmenL lf any
lLhlum or amoLrlglne
lLhlum/ amoLrlglne
8esL evldence ln bloplar depresslon
Can also use Clanzaplne (alLernaLlvely CueLlaplne)
MonoLherapy
Cr wlLh lluoxeLlne
Add anLldepressanL (usually SS8l) only lf no
lmprovemenL seen even afLer 4 weeks
Conslder psychologlcal LreaLmenL lf posslble
76
WhaL ls your oplnlon of Lhe
presenLaLlon?
77
%he present,tion is comprehensive ,nd e,sy to follow.

1 SLrongly Agree
2 Agree
3 ulsagree
4 SLrongly ulsagree
ong Lerm managemenL ln a
paLlenL wlLh recurrenL affecLlve
eplsodes ln blpolar dlsorder
78
8lologlcal LreaLmenL of
blpolar dlsorder prophylaxls
lLhlum mosL robusL evldence
ALyplcal anLlpsychoLlcs Clanzaplne
AnLlepllepLlc medlcaLlon Sodlum valproaLe
carbamazeplne lamoLrlglne
79
lLhlum prophylaxls
Avold abrupL dlsconLlnuaLlon of lLhlum
8elapse lnLo manla usually 3 monLhs afLer dlsconLlnuaLlon
Sulclde raLe ln 1
sL
year off lLhlum 20 Llmes raLe when on
lLhlum
MonlLor blood levels
narrow LherapeuLlc lndex
WaLch for slde effecLs
1l1s
8l1s
1eraLogenlc
regnancy LesLs
ConLracepLlve advlce needed
urug lnLeracLlons wlLh lLhlum
nSAlu
ACLlnhlblLors
dlureLlcs
80
hyslcal care ln blpolar
dlsorder
MonlLorlng annual checks
WelghL
uleLary advlce
WelghL managemenL
sychologlcal
managemenL
C81 (mlld Lo moderaLe sympLoms)
sychoeducaLlon
Compllance wlLh medlcaLlon
Larly warnlng slgns
SLraLegles for relapse prevenLlon
Lnhance coplng skllls
lamlly lnLervenLlon
Plgh Lxpressed LmoLlons (LL) problem solvlng
communlcaLlon
Soclal managemenL
Self help groups
LmploymenL educaLlon
Pouslng
llnances/ 8eneflLs
egal
LxLra supporL afLer llfe evenLs
WhaL ls your oplnlon of Lhe
presenLaLlon?
84
%he present,tion is comprehensive ,nd e,sy to follow.

1 SLrongly Agree
2 Agree
3 ulsagree
4 SLrongly ulsagree
8ole lay vlgneLLe 1 (explaln
dlagnosls and LreaLmenL)
83
Check whaL you know
1rue or lalse
86
uysLhymla and ma[or depresslve eplsodes can occur and
are called double depresslon'

1 1rue
2 lalse
Check whaL you know
1rue or lalse
87
8lpolar dlsorder ls more common ln female

1 1rue
2 lalse
Check whaL you know
1rue or lalse
88
1here ls an excess of llfe evenLs precedlng depresslon
buL noL manla

1 1rue
2 lalse
Check whaL you know
1rue or lalse
89
ALyplcal depresslon may be characLerlzed by
hypersomnla and overeaLlng

1 1rue
2 lalse
Check whaL you know
1rue or lalse
90
Alcohollsm ls one of Lhe predlcLors of repeaLlng
dellberaLe self harm

1 1rue
2 lalse
leedback
1hls sesslon has glven me a good
undersLandlng of Lhe sub[ecL
1 SLrongly dlsagree
2 ulsagree
3 neuLral
4 Agree
3 SLrongly agree
1he lecLurer sLlmulaLed my
lnLeresL ln Lhe sub[ecL
1 SLrongly dlsagree
2 ulsagree
3 neuLral
4 Agree
3 SLrongly agree
1he lecLurer relaLed Lhe sub[ecL
maLLer Lo pracLlce and currenL
avallable evldence
1 SLrongly dlsagree
2 ulsagree
3 neuLral
4 Agree
3 SLrongly agree
1he lecLurer encouraged me
Lo Lhlnk and quesLlon durlng
Lhe sesslon
1 SLrongly dlsagree
2 ulsagree
3 neuLral
4 Agree
3 SLrongly agree
1he explanaLlons glven by Lhe
lecLurer were clear
1 SLrongly dlsagree
2 ulsagree
3 neuLral
4 Agree
3 SLrongly agree
lease remember Lo save your sesslon uslng
Save Sesslon" on Lhe 1urnlngpolnL Lab