A 65-year-old man presents with a 6-week history of low mood after being made redundant. He reports difficulty sleeping, poor concentration, and loss ...

Question

A 65-year-old man presents with a 6-week history of low mood after being made redundant. He reports difficulty sleeping, poor concentration, and loss of interest in hobbies. He drinks 28 units of alcohol per week. PHQ-9 score is 12 (moderate depression). He has no suicidal ideation. He has no past psychiatric history. What is the MOST appropriate first-line management?

Accepted Answer

Offer a low-intensity psychological intervention (e.g., guided self-help, computerised CBT) and address alcohol use

Answer

Start Fluoxetine 20 mg immediately

Answer

Start Mirtazapine 45 mg at night

Answer

Refer to secondary care psychiatry

Answer

No treatment needed - this is a normal grief reaction

uk-dgm MCQ (SBA): Stepped Care for Moderate Depression