A 65-year-old woman presents with low mood, anhedonia and early morning waking for 3 months. She has recurrent thoughts that life is not worth living ...

Question

A 65-year-old woman presents with low mood, anhedonia and early morning waking for 3 months. She has recurrent thoughts that life is not worth living but denies active plans. There are no psychotic symptoms. What is the most appropriate initial management in primary care?

Accepted Answer

Assess suicide risk in detail and offer an SSRI plus psychological support

Answer

Prescribe benzodiazepines alone for sleep

Answer

Arrange routine review in 6 months without further action

Answer

Tell her to “pull herself together” and focus on work

Answer

Admit all patients with depression urgently to hospital

uk-plab-1 MCQ (SBA): Major depressive disorder

A 65-year-old woman presents with low mood, anhedonia and early morning waking for 3 months. She has recurrent thoughts that life is not worth living but denies active plans. There are no psychotic symptoms. What is the most appropriate initial management in primary care?