Persistent Depressive Disorder Case Studies & Practical Application 4

Question 1

A clinician sees a patient who meets full PDD criteria. The patient also reports two prior episodes that met full MDD criteria, each lasting about 4 months. How does this history affect the current PDD diagnosis?

Accepted Answer

Prior MDD episodes do not preclude a current PDD diagnosis

Answer

A history of discrete MDD episodes does not exclude a current PDD diagnosis; the conditions can coexist longitudinally.

Question 2

A nurse practitioner is evaluating whether a patient's depressive symptoms are due to PDD or a medical condition (hypothyroidism). What is the most important first step?

Accepted Answer

Order a TSH and relevant metabolic labs before diagnosing PDD

Answer

DSM-5 requires ruling out general medical conditions (e.g., hypothyroidism) that could cause depressive symptoms before assigning a PDD diagnosis.

Question 3

A 32-year-old with PDD tells her therapist she feels completely numb and hopeless. She says, 'Things will never get better, so why try?' This cognition is most consistent with which PDD-related cognitive pattern?

Accepted Answer

Chronic negative self-schema and hopelessness

Answer

Chronic hopelessness and negative self-schemas are hallmark cognitive features in PDD that often become entrenched over the long illness course.

Question 4

A patient with PDD is reluctant to try medication because 'I've always been this way.' What motivational strategy is most appropriate to address this barrier?

Accepted Answer

Psychoeducation about PDD as a treatable condition, not a personality trait

Answer

Psychoeducation that reframes PDD as a neurobiological disorder rather than a character flaw can reduce stigma and increase treatment engagement.

Question 5

A clinical researcher notes that patients with PDD often show delayed treatment response compared to those with acute MDD. What treatment implication does this have?

Accepted Answer

Adequate antidepressant trials for PDD may require 8–12 weeks or longer

Answer

Chronic depression including PDD often requires longer antidepressant trials (8–12 weeks) before declaring non-response and adjusting treatment.

Persistent Depressive Disorder Practice Test

Persistent Depressive Disorder Practice Test

Persistent Depressive Disorder Case Studies & Practical Application 4