Question

A 42-year-old woman presents with low mood, anhedonia, poor sleep and impaired concentration for 2 months. She denies suicidal ideation. PHQ‑9 score is 17 (moderate depression). She has no previous mental health problems. What is the most appropriate first-line management in primary care?

Accepted Answer

Offer an SSRI such as Sertraline plus psychological therapy (e.g. CBT)

Answer

Offer CBT only and avoid antidepressants at this stage

Answer

Start a benzodiazepine as monotherapy

Answer

Refer immediately to crisis services

Answer

Start tricyclic antidepressant as first-line

Practice question

A 42-year-old woman presents with low mood, anhedonia, poor sleep and impaired concentration for 2 months. She denies suicidal ideation. PHQ‑9 score is 17 (moderate depression). She has no previous mental health problems. What is the most appropriate first-line management in primary care?