Mental Health and Behavioural Medicine
Mental health and behavioural medicine tests recognition and safe first-line management of depression, anxiety, self-harm, psychosis, substance misuse and medically unexplained symptoms. The exam emphasises risk assessment, stigma-free communication and stepped care.
Core rules
- Screening tools such as PHQ-9 and GAD-7 support but do not replace clinical assessment.
- Ask directly about suicidal thoughts, plans, means and protective factors; assess risk and document a safety plan.
- For moderate-to-severe depression, offer psychological therapy and/or an SSRI; review response and suicidality early.
- Avoid benzodiazepines beyond short-term crisis use because of dependence and falls.
- Screen alcohol use with AUDIT-C; assess withdrawal risk before abrupt cessation.
- Consider bipolar disorder before starting antidepressants; screen for mania.
Worked example
A 35-year-old man reports insomnia and low mood; PHQ-9 is 16. He asks for a sleeping tablet. Ask about suicide, alcohol, mania and psychosocial stressors. Offer CBT-based support and an SSRI, with sleep hygiene and early review, rather than a benzodiazepine. Reasoning: the presentation is moderate depression and insomnia; treating the depression addresses both.
Traps
Not asking about suicide; missing bipolar disorder; stopping SSRIs abruptly; and dismissing physical symptoms as purely psychological.