Persistent Depressive Disorder Persistent Depressive Disorder Treatment & Therapeutic Interventions 1 — Questions and Answers
Question 1: Which class of antidepressant is considered a first-line pharmacological treatment for Persistent Depressive Disorder?
- Tricyclic antidepressants (TCAs)
- Selective serotonin reuptake inhibitors (SSRIs) (Correct answer)
- Monoamine oxidase inhibitors (MAOIs)
- Antipsychotics
Correct answer: Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are recommended as first-line pharmacotherapy for PDD due to their favorable safety and tolerability profile.
Question 2: Which psychotherapy has the strongest evidence base for treating Persistent Depressive Disorder specifically, compared to general depression therapies?
- Dialectical Behavior Therapy (DBT)
- Cognitive Behavioral Analysis System of Psychotherapy (CBASP) (Correct answer)
- Acceptance and Commitment Therapy (ACT)
- Interpersonal Therapy (IPT)
Correct answer: Cognitive Behavioral Analysis System of Psychotherapy (CBASP)
CBASP was developed specifically for chronic depression/PDD and has the strongest evidence for this population.
Question 3: A patient with PDD has had an inadequate response to a therapeutic dose of an SSRI for 8 weeks. What is the recommended next step?
- Immediately switch to an MAOI
- Augment with an atypical antipsychotic or switch to an SNRI (Correct answer)
- Discontinue all medications and use therapy alone
- Double the SSRI dose without further evaluation
Correct answer: Augment with an atypical antipsychotic or switch to an SNRI
After an adequate SSRI trial without sufficient response, augmentation or switching to an SNRI is the evidence-based next step.
Question 4: How long should pharmacotherapy typically be continued in a patient with Persistent Depressive Disorder after achieving remission?
- 3 months
- 6 months
- At least 2 years or long-term (Correct answer)
- Until the patient requests to stop
Correct answer: At least 2 years or long-term
Due to the high relapse rate in PDD, guidelines recommend at least 2 years of maintenance therapy, often long-term.
Question 5: Which therapeutic approach is most effective when combined with antidepressant medication for Persistent Depressive Disorder, according to major clinical trials?
- Medication alone is always superior
- Psychotherapy alone without medication
- Combined pharmacotherapy and psychotherapy (Correct answer)
- Electroconvulsive therapy (ECT) as first-line
Correct answer: Combined pharmacotherapy and psychotherapy
Research consistently shows that combining antidepressant medication with psychotherapy produces superior outcomes versus either alone in chronic depression.
Question 6: Behavioral Activation (BA) as a component of CBT for PDD primarily targets which maintaining factor?
- Cognitive distortions about the future
- Avoidance and reduced engagement with rewarding activities (Correct answer)
- Interpersonal conflicts with family members
- Sleep architecture disruption
Correct answer: Avoidance and reduced engagement with rewarding activities
Behavioral Activation directly counters the withdrawal and avoidance patterns that maintain low mood in PDD.
Persistent Depressive Disorder Persistent Depressive Disorder Treatment & Therapeutic Interventions 1
Which class of antidepressant is considered a first-line pharmacological treatment for Persistent Depressive Disorder?