Persistent Depressive Disorder Case Studies & Practical Application 2

Question 1

A 35-year-old woman reports feeling low-grade depression for the past 3 years, during which she has never felt well for more than 2 months at a time. She denies any manic or hypomanic episodes. What is the most appropriate diagnosis?

Accepted Answer

Persistent Depressive Disorder (Dysthymia)

Answer

PDD requires depressed mood for at least 2 years with no symptom-free period longer than 2 months, which matches this presentation.

Question 2

A patient with confirmed PDD develops a full major depressive episode. How should this be documented diagnostically?

Accepted Answer

Diagnose PDD with concurrent MDD (double depression)

Answer

When a major depressive episode occurs in the context of PDD, the appropriate term is 'double depression,' and both diagnoses can be documented.

Question 3

A clinician is treating a 42-year-old man with PDD using CBT. After 12 sessions he reports no change. What is the most evidence-based next step?

Accepted Answer

Add pharmacotherapy (SSRI) to ongoing psychotherapy

Answer

Combined treatment (psychotherapy plus antidepressant medication) shows superior outcomes for PDD compared to either modality alone.

Question 4

A 28-year-old presents with depressed mood since age 18, poor concentration, low self-esteem, and hopelessness. She says, 'This is just who I am.' This statement most likely reflects which PDD characteristic?

Accepted Answer

Ego-syntonic nature of long-standing PDD

Answer

Patients with chronic PDD often experience their symptoms as part of their personality (ego-syntonic), making them less likely to seek help.

Question 5

Which medication class has the strongest evidence base for treating Persistent Depressive Disorder in adults?

Accepted Answer

SSRIs and SNRIs

Answer

SSRIs and SNRIs are first-line pharmacological treatments for PDD, supported by multiple randomized controlled trials.

Persistent Depressive Disorder Practice Test

Persistent Depressive Disorder Practice Test

Persistent Depressive Disorder Case Studies & Practical Application 2