Persistent Depressive Disorder Persistent Depressive Disorder Diagnosis & Assessment 2 — Questions and Answers
Question 1: What specifier is used in DSM-5 when a full Major Depressive Episode occurs during the course of Persistent Depressive Disorder?
- With anxious distress
- With double depression
- With intermittent major depressive episodes (Correct answer)
- With melancholic features
Correct answer: With intermittent major depressive episodes
DSM-5 uses the specifier 'with intermittent major depressive episodes' when full MDE criteria are met during PDD.
Question 2: Which of the following conditions must be ruled out before diagnosing Persistent Depressive Disorder?
- Bipolar I Disorder with depressive episodes (Correct answer)
- Social Anxiety Disorder
- Specific Phobia
- Attention-Deficit/Hyperactivity Disorder
Correct answer: Bipolar I Disorder with depressive episodes
A diagnosis of PDD cannot be made if the depressive symptoms are better explained by Bipolar Disorder or cyclothymia.
Question 3: Which medical condition is most important to exclude before diagnosing Persistent Depressive Disorder?
- Hypothyroidism (Correct answer)
- Type 2 Diabetes
- Chronic migraines
- Irritable bowel syndrome
Correct answer: Hypothyroidism
Hypothyroidism can produce chronic low mood and fatigue that closely mimics PDD and must be ruled out via lab work.
Question 4: The Hamilton Rating Scale for Depression (HAM-D) is best suited for which purpose in the context of PDD?
- Initial screening in primary care
- Measuring treatment response severity over time (Correct answer)
- Diagnosing PDD vs. MDD
- Screening for suicidal ideation only
Correct answer: Measuring treatment response severity over time
The HAM-D is a clinician-administered scale used to measure symptom severity and track response to treatment over time.
Question 5: What is the key DSM-5 criterion that distinguishes Persistent Depressive Disorder from Major Depressive Disorder in terms of symptom-free periods?
- Symptoms must never fully remit
- No symptom-free period longer than 2 months in 2 years (Correct answer)
- No symptom-free period longer than 1 month in 2 years
- No symptom-free period at all
Correct answer: No symptom-free period longer than 2 months in 2 years
DSM-5 specifies that PDD symptoms must not be absent for more than 2 consecutive months over the 2-year period.
Question 6: Which of the following best describes the diagnostic approach for PDD in a clinical interview?
- Focus only on the past 2 weeks of symptoms
- Take a longitudinal mood history spanning at least 2 years (Correct answer)
- Administer a structured PTSD assessment first
- Rely primarily on family history of depression
Correct answer: Take a longitudinal mood history spanning at least 2 years
Because PDD is defined by chronicity, a thorough longitudinal mood history of at least 2 years is essential for diagnosis.
Persistent Depressive Disorder Persistent Depressive Disorder Diagnosis & Assessment 2
What specifier is used in DSM-5 when a full Major Depressive Episode occurs during the course of Persistent Depressive Disorder?