Anxiety & Depression
COVID-19 clinical presentation
<div class="redbox">
<p style="text-size:12px;">COVID-19 can present with a myriad of symptoms so should probably be on most differential diagnosis lists during the pandemic</p>
<li><a href="https://productivemedic.com/covid-remote-assessment/" target="_blank">COVID assessment, DDx and complications</a></li>
<li><a href="https://www.google.com/imgres?imgurl=https%3A%2F%2Ff6publishing.blob.core.windows.net%2F2ab0884c-0618-4586-aaf1-41004e6ad656%2FWJCC-8-3956-g002.png&imgrefurl=https%3A%2F%2Fwww.wjgnet.com%2F2307-8960%2Ffull%2Fv8%2Fi18%2F3956.htm&tbnid=I0G0VvXcx_akPM&vet=12ahUKEwj1_43FsrnuAhUH-YUKHSoZAFQQMygYegUIARCwAQ..i&docid=IBDQMbzRItpvKM&w=3307&h=2168&q=covid%2019%20presentation&safe=strict&ved=2ahUKEwj1_43FsrnuAhUH-YUKHSoZAFQQMygYegUIARCwAQ" target="_blank">Clinical presentation summary infographic</a></li>
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*Common causes
- General Anxiety Disorder
- Panic disorder
- Depression
- Alcohol abuse
- Medication-induced anxiety
— suggested by anxiety triggered by exposure to medications including salbutamol, theophylline, corticosteroids, antidepressants, and some herbal medicines. Caffeine may also be a trigger. Withdrawal from CNS depressants can also trigger anxiety. - Drug abuse
*Must not miss!
- Psychosis and schizophrenia
<div style="text-align:center;"> <a href="https://www.bmj.com/content/357/bmj.j4578" target="_blank">Early psychosis for the non-specialist doctor</a><br> <a href="https://www.bmj.com/content/bmj/suppl/2017/11/08/bmj.j4578.DC1/psychosis_v28.pdf" target="_blank">BMJ inforgraphic</a> </div> - Bipolar disorder
- Anorexia nervosa
- Physical disorders that can produce anxiety like symptoms
- Subdural haematoma
- SOL
*Easily missed
Red flags
- Suicide risk
- Risk to others
- Paranoia
- Psychotic symptoms
- Drug & Alcohol abuse
Investigations to consider
- Usually no investigations required
- FBC, U&Es, LFTs, TFTs, Glucose, Bone profile
- Urine toxicology screen
- ECG