Persistent Depressive Disorder General 5 — Questions and Answers
Question 1: Which of the following best characterizes the prognosis of Persistent Depressive Disorder compared to Major Depressive Disorder?
- PDD has a better prognosis and shorter overall duration
- PDD is associated with a more chronic course and lower remission rates (Correct answer)
- PDD and MDD have identical long-term prognoses
- PDD never responds to antidepressant treatment
Correct answer: PDD is associated with a more chronic course and lower remission rates
PDD is associated with a more chronic, treatment-resistant course and lower rates of full remission compared to episodic MDD.
Question 2: Which dietary or lifestyle factor has emerging evidence as an adjunctive intervention in Persistent Depressive Disorder?
- High sodium diet
- Regular aerobic exercise (Correct answer)
- Complete sleep restriction
- Caffeine supplementation
Correct answer: Regular aerobic exercise
Regular aerobic exercise has growing evidence as an adjunctive treatment that can modestly improve depressive symptoms in chronic depression.
Question 3: How does PDD affect occupational functioning compared to episodic MDD between episodes?
- PDD has no impact on occupational functioning
- PDD produces more consistent but often subtle occupational impairment (Correct answer)
- PDD impairs functioning only during acute exacerbations
- MDD causes more chronic occupational impairment than PDD
Correct answer: PDD produces more consistent but often subtle occupational impairment
Because PDD is persistent rather than episodic, it produces a more constant, if sometimes subtle, drain on occupational and social functioning.
Question 4: Which of the following statements about the relationship between PDD and Bipolar Disorder is accurate?
- PDD can be diagnosed concurrently with Bipolar I or II Disorder
- PDD diagnosis is excluded if the patient has ever met criteria for a manic or hypomanic episode (Correct answer)
- PDD is considered a subtype of Bipolar II Disorder
- Cyclothymia and PDD are the same diagnosis
Correct answer: PDD diagnosis is excluded if the patient has ever met criteria for a manic or hypomanic episode
If a patient has ever experienced a manic or hypomanic episode, PDD cannot be diagnosed; the presentation would fall under a bipolar spectrum disorder.
Question 5: A patient with PDD who achieves remission then relapses within 2 months would most accurately be described as having which course pattern?
- Recovered from PDD with a new onset MDE
- Relapse of PDD with no change in diagnosis (Correct answer)
- New-onset Cyclothymic Disorder
- Adjustment Disorder with depressed mood
Correct answer: Relapse of PDD with no change in diagnosis
Relapse within 2 months of remission is considered a continuation of the same PDD episode, consistent with the disorder's chronic nature.
Question 6: Which specifier is used when a patient with PDD experiences depressive episodes between which they return to their baseline PDD symptoms?
- With persistent major depressive episode
- With pure dysthymic syndrome
- With intermittent major depressive episodes, with current episode (Correct answer)
- With anxious distress
Correct answer: With intermittent major depressive episodes, with current episode
'With intermittent major depressive episodes, with current episode' applies when the patient currently meets full MDE criteria on top of a PDD baseline.
Question 7: Which of the following is a key distinguishing feature between PDD and Adjustment Disorder with Depressed Mood?
- Adjustment disorder requires the presence of a psychosocial stressor (Correct answer)
- PDD requires a documented stressor within 3 months of onset
- Adjustment disorder lasts longer than PDD by definition
- Both disorders have identical treatment approaches
Correct answer: Adjustment disorder requires the presence of a psychosocial stressor
Adjustment Disorder requires an identifiable psychosocial stressor within 3 months of onset, whereas PDD does not require a precipitating stressor.
Persistent Depressive Disorder General 5
Which of the following best characterizes the prognosis of Persistent Depressive Disorder compared to Major Depressive Disorder?