Persistent Depressive Disorder General 2 — Questions and Answers
Question 1: Which specifier is added to a Persistent Depressive Disorder diagnosis when criteria for a Major Depressive Episode are met simultaneously?
- With pure dysthymic syndrome
- With persistent major depressive episode (Correct answer)
- With anxious distress
- With mixed features
Correct answer: With persistent major depressive episode
When full MDE criteria are met during PDD, the specifier 'with persistent major depressive episode' is applied.
Question 2: A patient with PDD reports that they cannot remember ever feeling happy. This is most consistent with which specifier?
- With anxious distress
- With melancholic features
- With early onset (Correct answer)
- With pure dysthymic syndrome
Correct answer: With early onset
Early onset (before age 21) is associated with a more pervasive, lifelong depressive temperament, often including difficulty recalling euthymic periods.
Question 3: What is the minimum number of the six PDD criterion B symptoms required for diagnosis in adults?
- One
- Two (Correct answer)
- Three
- Four
Correct answer: Two
DSM-5 requires at least two of the six criterion B symptoms (e.g., poor appetite, insomnia, low energy, low self-esteem, poor concentration, hopelessness).
Question 4: Which medication class has the strongest evidence base as a first-line pharmacotherapy for Persistent Depressive Disorder?
- Tricyclic antidepressants (TCAs)
- Monoamine oxidase inhibitors (MAOIs)
- Selective serotonin reuptake inhibitors (SSRIs) (Correct answer)
- Antipsychotics
Correct answer: Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are considered first-line pharmacotherapy for PDD due to their efficacy and favorable tolerability profile.
Question 5: During the required 2-year period for PDD diagnosis in adults, the patient must not be symptom-free for more than how long?
- 1 month
- 2 months (Correct answer)
- 3 months
- 6 months
Correct answer: 2 months
The DSM-5 requires that the individual not be asymptomatic for more than 2 consecutive months during the 2-year period.
Question 6: Which psychotherapy has the most robust evidence specifically designed and tested for Persistent Depressive Disorder?
- Dialectical Behavior Therapy (DBT)
- Cognitive Behavioral Analysis System of Psychotherapy (CBASP) (Correct answer)
- Interpersonal Therapy (IPT)
- Exposure and Response Prevention (ERP)
Correct answer: Cognitive Behavioral Analysis System of Psychotherapy (CBASP)
CBASP was specifically developed for chronic depression and has the strongest evidence base for PDD treatment.
Question 7: PDD is differentiated from a Major Depressive Episode primarily by which factor?
- Severity of symptoms
- Presence of suicidal ideation
- Duration and chronicity (Correct answer)
- Number of symptoms required
Correct answer: Duration and chronicity
PDD is defined by its chronicity (≥2 years) rather than symptom severity, whereas MDE is defined by its episode structure.
Persistent Depressive Disorder General 2
Which specifier is added to a Persistent Depressive Disorder diagnosis when criteria for a Major Depressive Episode are met simultaneously?