Persistent Depressive Disorder Research & Evidence-Based Practice 2 — Questions and Answers
Question 1: Which rating scale is most commonly used in research studies to measure symptom severity in Persistent Depressive Disorder (PDD)?
- Hamilton Depression Rating Scale (HAM-D) (Correct answer)
- Beck Anxiety Inventory (BAI)
- Patient Health Questionnaire-2 (PHQ-2)
- Generalized Anxiety Disorder-7 (GAD-7)
Correct answer: Hamilton Depression Rating Scale (HAM-D)
The Hamilton Depression Rating Scale (HAM-D) is widely used in PDD research to assess symptom severity and treatment response.
Question 2: Research on PDD indicates that the condition is associated with what pattern of cortisol secretion compared to healthy controls?
- Elevated basal cortisol and blunted cortisol awakening response (Correct answer)
- Decreased basal cortisol with normal diurnal variation
- Normal cortisol levels but elevated ACTH
- Hypocortisolism with exaggerated stress reactivity
Correct answer: Elevated basal cortisol and blunted cortisol awakening response
Studies show that individuals with PDD often exhibit elevated basal cortisol and a blunted cortisol awakening response, reflecting chronic HPA axis dysregulation.
Question 3: Evidence from longitudinal research suggests that early onset PDD (before age 21) is associated with which outcome compared to adult-onset PDD?
- Greater chronicity, higher comorbidity rates, and poorer treatment response (Correct answer)
- Shorter episode duration and better spontaneous remission
- Lower rates of personality disorder comorbidity
- Similar outcomes but faster response to antidepressants
Correct answer: Greater chronicity, higher comorbidity rates, and poorer treatment response
Research consistently shows that early-onset PDD is associated with greater chronicity, higher rates of comorbid conditions, and generally poorer treatment outcomes.
Question 4: A meta-analysis of psychotherapy for PDD would most likely find which result regarding Cognitive Behavioral Analysis System of Psychotherapy (CBASP)?
- CBASP is more effective for chronic depression than generic CBT (Correct answer)
- CBASP shows no advantage over supportive therapy
- CBASP is only effective when combined with medication
- CBASP has higher dropout rates than standard CBT
Correct answer: CBASP is more effective for chronic depression than generic CBT
CBASP was specifically designed for chronic depression and meta-analyses support its superior efficacy over generic CBT for PDD populations.
Question 5: In randomized controlled trials comparing antidepressant monotherapy to combination therapy (antidepressant + psychotherapy) for PDD, what does the evidence typically show?
- Combination therapy produces superior outcomes to either treatment alone (Correct answer)
- Antidepressant monotherapy is equivalent to combination therapy
- Psychotherapy alone is superior to combination approaches
- Combination therapy increases side effects without additional benefit
Correct answer: Combination therapy produces superior outcomes to either treatment alone
RCTs consistently demonstrate that combining antidepressant medication with psychotherapy produces better outcomes for PDD than either treatment alone.
Question 6: Research on the double depression phenomenon (PDD + MDD) indicates what about treatment response?
- MDD episodes remit but underlying PDD persists, requiring ongoing treatment (Correct answer)
- Double depression responds identically to MDD without PDD
- The MDD episode rarely responds to antidepressants in this population
- Double depression typically resolves completely after one treatment course
Correct answer: MDD episodes remit but underlying PDD persists, requiring ongoing treatment
Studies show that while the superimposed MDD episode may remit with treatment, the underlying PDD typically persists, necessitating continued long-term treatment.
Question 7: Which finding from genetic research is most relevant to understanding PDD's heritability?
- PDD has moderate heritability (~40%) with polygenic risk factors similar to MDD (Correct answer)
- PDD is primarily environmentally determined with minimal genetic contribution
- PDD has higher heritability than MDD (~80%) due to single gene effects
- Twin studies show near-zero concordance rates for PDD
Correct answer: PDD has moderate heritability (~40%) with polygenic risk factors similar to MDD
Genetic research indicates PDD has moderate heritability around 40%, with multiple genes contributing small effects, similar in architecture to major depressive disorder.
Persistent Depressive Disorder Research & Evidence-Based Practice 2
Which rating scale is most commonly used in research studies to measure symptom severity in Persistent Depressive Disorder (PDD)?