GP Training - Catalogue

Social phobia is also known as social anxiety disorder and is
characterised by a fear of negative evaluation. This learning module
reviews a case about Sabrina, 20, is a second-year law student who is
a longstanding patient at your surgery. She describes a history of vague
"stomach pains", but is otherwise well. However, general history-taking
reveals debilitating anxiety over her university studies. Sabrina reveals
that she is morbidly fearful of the prospect of participating in moot
(mock) trials in her fourth year of studies, where she will need to make
presentations to a mock judge in front of her peers. She discloses that
she has decided to find an alternative career, due to her debilitating
shyness.

At the conclusion of this online learning module you will be able to:

• understand the impact of social phobia on the lives of affected patients
• recognise the value of addressing the illness, whether social phobia is the primary presentation, or whether diagnosis is incidental to a different presenting complaint
• select and appropriately adjust the treatment plan, based on patient needs and safety
• manage and care for patients who resist or refuse secondary care services, using evidence-based guidelines
• address issues associated with stigma.

Anxiety impairs social, familial and occupational function and co-morbid
depression is common. GPs play a key role in identifying, treating
and/or referring patients. Specific and effective interventions should be
applied. This online learning module reviews the case of Janet, a 58-
year-old mother of four who has been a patient at your practice for the
past 5 years. She presents asking for a stronger headache medication,
as the analgesic medication she has been using is no longer providing
relief. On enquiry, Janet tells you that she’s “all nerves” and describes
feeling constantly worried, distracted, restless, exhausted and unable
to relax. Her attempts to control her persistent worrying only intensify
her distress, and she tells you that she feels “out of control”. Janet says
she has difficulty concentrating and feels overwhelmed, on edge,
unable to cope with her household chores.

At the conclusion of this online learning module you will be able to:

• identify appropriate investigations and differential diagnoses for GAD
• recognise common comorbidities associated with GAD
• work towards maximising the efficacy of the shared care team
• understand the GP’s role in contributing to ongoing assessment and patient safety
• select from among pharmacological and non-pharmacological treatment approaches to GAD and assess their effectiveness in an individual setting.

In clinical practice, OCD is usually a chronic illness with a waxing and
waning course. This online learning module reviews the case of
Connie, a 24-year-old new patient. She is married, lives with her
husband and 5 month-old daughter. She presents requesting a “sterile
hand cream” to prevent her hands from drying out. She washes her
hands “often”, as she is fearful of “contaminating” her baby. Review
patient management and treatment options based on expert opinion
and recent evidence.

At the conclusion of this online learning module you will be able to:

• understand the heterogeneous nature of obsessive-compulsive disorders
• select from within the range of appropriate pharmacological options for symptom control and patient safety
• tailor treatment strategies involving behavioural and other psychological therapies for patients, to facilitate optimal outcomes
• understand and enhance the potentially beneficial role of family and support people for people with OCD
• integrate patient support groups as part of long-term management of OCD

Presenting symptoms do not always give an unobscured indication of
the underlying condition. This online learning module reviews the case
of Julian, a 41-year-old businessman who presents with lethargy. He
finds it hard to get going in the mornings, and is irritable and difficult to
get along with at work. In the past he has used alcohol to help him
sleep and that he has gone through long periods of debilitating
insomnia. He spent time in several drug rehabilitation programs, and
was diagnosed at one point with depression. He claims to have
controlled his illicit drug use, and now completely abstains. He
wonders if the depression is “creeping back into his brain”, as he has
dark thoughts and “can spend days on end feeling heavy and low”. He
calls these his “low energy phases”.

At the conclusion of this online learning module you will be able to:

• understand that patients with depression present with a variety of symptoms, and identify patients in need of depression screening
• recognise the specific challenges associated with managing depression in primary care
• identify obstacles to adherence, and implement appropriate psychoeducation strategies to aid adherence
• differentiate between treatment-resistant depression, and an incomplete trial period of antidepressants
• engage patients in a treatment plan, undertake appropriate risk assessment and improve patient safety.

The prevalence of dementia doubles with every five years of age beyond
the age of 65 in Australia. This online learning module reviews the case
of Edith, a 77-year-old retired primary school teacher and long-standing
patient at your surgery. She is in good health generally. She lives
independently with regular visits from her daughter Joan. Edith
presents with her daughter Joan to request vaccination against swine
flu. She requires prompting to remember the reason for her visit and
cannot recall today’s date. General history-taking reveals repetitive
questioning and comments.

Learn about the contemporary screening tools for the assessment of
cognitive function in potential Alzheimer’s disease and differential
diagnoses such as normal ageing, delirium or depression. Carer
perspectives are also addressed. Treatment and patient management
options are discussed.

At the conclusion of this online learning module you will be able to:

• Differentiate between cognitive impairment and depressive features of Alzheimer’s disease.
• Identify appropriate screening tools for depression in Alzheimer’s disease.
• Engage patients and carers in a treatment plan and ensure safety for Alzheimer’s patients.
• Refer to and work collaboratively with appropriate specialists and allied-health professionals.
• Help support carers of patients with Alzheimer’s disease.

Menopause is linked to both life changes and physiological changes.
This online learning module reviews the case of Sandra, a 56 year-old
accountant. Sandra and her husband have recently downsized to a flat.
She cared for her elderly mother who died about 6 weeks ago. She is
experiencing an ‘empty nest’. Her husband has not been very
supportive. Sandra presents with complaints of lethargy, being unable
to get going and feeling "unwell". She says she has been unmotivated
at work and has been taking off excessive sick days. She is worried she
is going to lose her job because she was called into her boss’ office to
discuss her poor performance. You also notice that she appears more
dishevelled than usual. Review treatment options and develop a patient
management plan using expert advice and recent evidence.

At the conclusion of this online learning module you will be able to:

• Identify patient factors and menopausal symptoms that are associated with a greater risk of depression.
• Describe the risk of onset of depression during the menopausal transition in women with and without a history of depression.
• Discuss screening and assessment methods to identify the spectrum of depressive symptoms in patients going through the menopausal transition.
• Review management options after symptom assessment.
• Initiate safe and effective antidepressant treatment where necessary.