Mood disorders
Depression, bipolar disorder and suicide risk. The AMC tests diagnosis, treatment choice and risk assessment.
High-yield points
Major depression: 5 or more DSM-5 symptoms for at least 2 weeks, including low mood or loss of interest.
Always ask about suicidal thoughts directly; asking does not increase risk.
First line for moderate depression: psychological therapy (CBT) and/or an SSRI such as sertraline or escitalopram; review within 1-2 weeks, especially under 25s.
Antidepressants take 2-6 weeks to work; continue for at least 6-12 months after remission.
Screen for bipolar disorder before starting an antidepressant; mania can be triggered.
Bipolar maintenance: lithium is the gold standard; typical maintenance level 0.6-0.8 mmol/L; monitor renal and thyroid function.
Lithium toxicity: coarse tremor, vomiting, confusion, ataxia; triggered by dehydration, NSAIDs, ACE inhibitors and diuretics.
Serotonin syndrome: clonus, hyperreflexia, agitation, hyperthermia after serotonergic drug combinations.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| Who manages depression | Psychiatrist-led, often in hospital outpatients; Tele-MANAS helpline. | Mostly GP-led. A Mental Health Treatment Plan gives Medicare-subsidised psychology sessions (Better Access). |
| Treatment | Antidepressants are often the main treatment. | Psychological therapy first for mild to moderate depression; SSRIs added for moderate to severe. |
| Young people | Few dedicated youth services. | headspace: free centres for 12-25 year olds. |
| Crisis support | Tele-MANAS 14416. | Lifeline 13 11 14; Beyond Blue. Screening tools K10 and PHQ-9. |
Who manages depression
India (MBBS)
Psychiatrist-led, often in hospital outpatients; Tele-MANAS helpline.
Australia (AMC): what the exam expects
Mostly GP-led. A Mental Health Treatment Plan gives Medicare-subsidised psychology sessions (Better Access).
Treatment
India (MBBS)
Antidepressants are often the main treatment.
Australia (AMC): what the exam expects
Psychological therapy first for mild to moderate depression; SSRIs added for moderate to severe.
Young people
India (MBBS)
Few dedicated youth services.
Australia (AMC): what the exam expects
headspace: free centres for 12-25 year olds.
Crisis support
India (MBBS)
Tele-MANAS 14416.
Australia (AMC): what the exam expects
Lifeline 13 11 14; Beyond Blue. Screening tools K10 and PHQ-9.
The Australian context
A GP can make a Mental Health Treatment Plan giving Medicare-subsidised sessions with a psychologist (Better Access). Young people aged 12-25 can use free headspace centres. Crisis lines include Lifeline 13 11 14. Depression screening tools commonly used in Australia include the K10 and PHQ-9.