Clinical Scenarios

Clinical Scenario



By the end of Family Medicine Clerkship, students will be able to:

1. To be able to screen for and diagnose depression including

a. using current criteria and other diagnostic and functional assessment tools

b. Mental status exam, including assessment of suicide/homicidal risk, and take appropriate action where necessary

2. Identify high risk factors for depression and suicide.

3. Describe variant presentations of depressed patients.

4. Propose a differential diagnosis for patients with depressed mood to rule out important secondary causes and an initial plan for investigation & management

5. Describe non-pharmacologic and pharmacologic approaches to management, including risks, benefits and limitations of the method(s) used

a. Pharmacologic

•         Mechanism of action

•         Medication classes & interactions

b. Non-pharmacologic

•         Resources available in community

•         Effect of/on family & social supports

Clinical Cards



Recommended Resources Addressing the Objectives

Treating Major Depressive Disorder (25 pages, but very large font, easy to read) *will change over time

Objectives covered: 1b, 5a (partial), 5b
American Psychiatric Assocication. Treating Major Depressive Disorder. 2010; Available at: Accessed June/11, 2014.
no pubmed ID

A Primary Care Focus on the Treatment of Patients With Major Depressive Disorder (6 pages text, 4 pages figures/tables) *will change over time

Objectives covered: 1a, 5ab
Weihs K, Wert JM. A primary care focus on the treatment of patients with major depressive disorder. Am J Med Sci 2011 Oct;342(4):324-330.

Screening for Depression in the Primary Care Population (15 pages, with template screening questionnaires at the end)

Objectives covered: 1ab, 2
Deneke DE, Schultz H, Fluent TE. Screening for Depression in the Primary Care Population. Prim Care 2014 Jun;41(2):399-420.

Various forms of depression (8 pages)

Objectives covered: 3
Benazzi F. Various forms of depression. Dialogues Clin Neurosci 2006;8(2):151-161.

DSM V – Depressive Disorders; sections on “Substance/Medication-Induced Depressive Disorder” and “Depressive Disorder Due to Another Medical Condition”

Objectives covered: 4
American Psychiatric Assocication. Depressive Disorders. 2013; Available at: Accessed June/26, 2014.
No PubMed ID

Foundational Knowledge

The Calgary Guide – Pathogenesis of major depression

Additional Resources

Psychotropic medications reference – with generic and brand names of different medications, and their action on various neuro-transmitters (2 pages)

Objectives covered: 5a
Preston J. Quick Reference to Psychotropic Medications. 2014; Available at: Accessed June/3, 2014.

Patient Information