Psyched episode 1: Diagnosing Depression with Dr. Ilana Shawn

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.

This episode covers the diagnosis of major depressive disorder (MDD), leveraging experience from Dr. Ilana Shawn, Staff Emergency and Outpatient Psychiatrist at St. Michael’s Hospital in Toronto.

In this episode we talk about a hypothetical case of someone presenting for the first time with a depressive illness. Using the metric of DALY (disability-adjusted life-years), we highlight the high global disease burden of depression. We then briefly discuss the purpose and limitations of using a diagnostic manual. We describe in depth the symptoms of depression using the mnemonic MSIGECAPS, including Dr. Shawn’s thoughts on how the they can be elicited more naturally in an assessment. We talk about common challenges in performing a suicide assessment, and the misconception that asking about suicide increases the risk of suicide. Finally, we highlight other medical and psychiatric conditions that can mimic depression.

The Learning Objectives for this episode are as follows. By the end of this episode, the listener will be able to:

• Understand the societal impact of depression

• Describe the diagnostic criteria of MDD

  • Describe strategies to elicit depression symptoms

  • Apply Mental State Exam findings to support or a diagnosis of depression

  • Understand the limitations of the Diagnostic and Statistical Manual (DSM)

• Perform a differential diagnosis of major depression

Guest Staff Psychiatrist: Dr. Ilana Shawn (St. Michael’s Hospital, Toronto)

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