Persistent Depressive Disorder Persistent Depressive Disorder Treatment & Therapeutic Interventions 2 — Questions and Answers
Question 1: Which SNRI has evidence supporting its use in Persistent Depressive Disorder and is commonly used when SSRIs are ineffective?
- Bupropion
- Venlafaxine (Correct answer)
- Mirtazapine
- Trazodone
Correct answer: Venlafaxine
Venlafaxine, an SNRI, is supported by evidence for chronic depression and is often used after SSRI failure.
Question 2: A patient with PDD is being treated with CBT. Which core cognitive intervention directly addresses the pervasive hopelessness characteristic of PDD?
- Graded task assignment
- Cognitive restructuring of negative automatic thoughts (Correct answer)
- Sleep hygiene training
- Social skills training
Correct answer: Cognitive restructuring of negative automatic thoughts
Cognitive restructuring challenges and modifies the negative automatic thoughts and hopeless schemas that sustain chronic depression.
Question 3: What is the main advantage of CBASP over standard CBT for patients with Persistent Depressive Disorder?
- It is shorter in duration
- It directly addresses the interpersonal dysfunction caused by early-onset chronic depression (Correct answer)
- It focuses exclusively on medication management
- It avoids exploration of childhood experiences
Correct answer: It directly addresses the interpersonal dysfunction caused by early-onset chronic depression
CBASP addresses the specific interpersonal and developmental consequences of early-onset chronic depression through situational analysis and disciplined personal involvement.
Question 4: For a patient with PDD who cannot tolerate SSRIs due to sexual side effects, which antidepressant is a reasonable alternative with a different side-effect profile?
- Paroxetine
- Bupropion (Correct answer)
- Citalopram
- Sertraline
Correct answer: Bupropion
Bupropion (NDRI) is associated with lower rates of sexual dysfunction compared to SSRIs and is a reasonable alternative.
Question 5: Which non-pharmacological intervention has emerging evidence as an adjunct for treatment-resistant Persistent Depressive Disorder?
- Transcranial magnetic stimulation (TMS) (Correct answer)
- Acupressure
- Dietary restriction
- Prolonged fasting
Correct answer: Transcranial magnetic stimulation (TMS)
Transcranial magnetic stimulation (TMS) has received FDA clearance for treatment-resistant depression and shows promise as an adjunct in PDD.
Question 6: In treating PDD, what is the significance of monitoring for the 'double depression' pattern during therapy?
- It indicates medication toxicity
- It signals the need to intensify treatment and address the superimposed MDE (Correct answer)
- It means the patient no longer has PDD
- It suggests a bipolar diagnosis
Correct answer: It signals the need to intensify treatment and address the superimposed MDE
When a full MDE develops within PDD, treatment intensity must increase as double depression carries worse prognosis and greater impairment.
Persistent Depressive Disorder Persistent Depressive Disorder Treatment & Therapeutic Interventions 2
Which SNRI has evidence supporting its use in Persistent Depressive Disorder and is commonly used when SSRIs are ineffective?