Persistent Depressive Disorder Persistent Depressive Disorder 4 — Questions and Answers
Question 1: What is the lifetime prevalence of Persistent Depressive Disorder in the United States?
- Less than 1%
- Approximately 2–3% (Correct answer)
- Approximately 10–15%
- Greater than 20%
Correct answer: Approximately 2–3%
Lifetime prevalence of PDD in the US is estimated at approximately 2–3% of the population.
Question 2: How does PDD typically affect social and occupational functioning compared to its symptomatic severity?
- Minimal impairment because symptoms are mild
- Significant impairment disproportionate to apparent symptom severity (Correct answer)
- Only occupational but not social impairment
- Only social but not occupational impairment
Correct answer: Significant impairment disproportionate to apparent symptom severity
Despite appearing less severe than MDD, PDD often causes significant functional impairment due to its chronic, unrelenting nature.
Question 3: Which finding differentiates PDD with pure dysthymic syndrome from PDD with intermittent major depressive episodes?
- Pure dysthymic syndrome requires hospitalization
- Pure dysthymic syndrome means full MDE criteria have never been met (Correct answer)
- Intermittent MDE requires psychotic features
- Pure dysthymia is treatment-resistant by definition
Correct answer: Pure dysthymic syndrome means full MDE criteria have never been met
The 'pure dysthymic syndrome' specifier applies when full MDE criteria have not been met during any part of the 2-year period.
Question 4: Which neurotransmitter system is most implicated in the pathophysiology of Persistent Depressive Disorder?
- Dopamine alone
- Serotonin and norepinephrine (Correct answer)
- GABA exclusively
- Acetylcholine exclusively
Correct answer: Serotonin and norepinephrine
Dysregulation of serotonin and norepinephrine systems is central to the neurobiological model of PDD, consistent with the efficacy of SSRIs and SNRIs.
Question 5: A patient reports feeling depressed most of the day, more days than not, for 2.5 years, with poor concentration and low self-esteem. There have been no symptom-free periods longer than 6 weeks. Which diagnosis is most consistent?
- Major depressive disorder, recurrent
- Adjustment disorder with depressed mood
- Persistent Depressive Disorder (Correct answer)
- Cyclothymic disorder
Correct answer: Persistent Depressive Disorder
Chronic low-grade depressed mood for over 2 years with associated PDD criteria and no prolonged remissions meets the DSM-5 criteria for PDD.
Question 6: Which statement about the course of PDD is most accurate?
- PDD typically resolves spontaneously within 1 year
- PDD has a chronic course often lasting a decade or more without treatment (Correct answer)
- PDD never responds to antidepressant medication
- PDD always converts to bipolar disorder
Correct answer: PDD has a chronic course often lasting a decade or more without treatment
Without treatment, PDD tends to follow a chronic course that can persist for many years or even decades.
Question 7: In PDD, which cognitive pattern is most characteristically prominent and contributes to treatment difficulty?
- Grandiosity and overconfidence
- Chronic pessimism and negative self-view (Correct answer)
- Rapid mood cycling
- Paranoid ideation
Correct answer: Chronic pessimism and negative self-view
A pervasive negative self-view and chronic pessimism are hallmark cognitive features of PDD that can undermine motivation for treatment.
Persistent Depressive Disorder Persistent Depressive Disorder 4
What is the lifetime prevalence of Persistent Depressive Disorder in the United States?