Mental Health
AKT High-Yield Breakdown
Mental health is one of the highest-yield AKT areas. The exam tests stepped-care models, NICE pharmacology thresholds, risk assessment principles, and the specific clinical features that distinguish conditions from one another. Expect scenario-based questions on when to prescribe, when to refer, and how to manage a deteriorating patient.
What You'll Learn
Master the PHQ-9/GAD-7 thresholds, NICE stepped care for depression and anxiety, antidepressant choice and switching, lithium monitoring, alcohol CAGE/AUDIT scoring, suicide risk assessment, and key safeguarding principles for the AKT.
Practise Mental Health MCQs
From PHQ-9 thresholds and stepped-care models to lithium toxicity, valproate contraindications, and Mental Health Act sections — tackle focused MCQs across the full Mental Health curriculum.
Depression
Depression affects around 1 in 6 adults in England. The AKT tests diagnosis thresholds, the NICE stepped-care model, first-line treatment choice, and when to add or switch medication.
Diagnosis and Severity
PHQ-9 scoring: 1–9 minimal/mild, 10–14 moderate, 15–19 moderately severe, 20–27 severe. NICE defines mild depression as fewer than 4 symptoms; mild–moderate as 4+ symptoms with mild impairment.
- Two core symptoms: persistent low mood AND/OR anhedonia (loss of pleasure) — at least one must be present for ≥2 weeks
- Additional symptoms: fatigue, sleep disturbance, appetite change, poor concentration, psychomotor change, guilt/worthlessness, suicidal ideation
- Exclude organic causes: hypothyroidism, anaemia, Addison's, medications (beta-blockers, steroids, OCP)
- Distinguish from adjustment disorder (identifiable stressor, resolves within 6 months), bereavement, and bipolar disorder
NICE Stepped-Care Model (NG222)
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