DEPRESSIVE DISORDERS PANCE PREP
PEARLS 2026/2027 | STUDY GUIDE,
PRACTICE QUESTIONS, ANSWERS & EXAM
REVIEW
1 of 27
Definition
Characterized by at least two consecutive years of prolonged, milder
elevations and milder depressions in mood that do not meet the
criteria for either full hypomanic episodes or major depressive
episodes
one of more years in adolescent
criteria for mania never met
symptoms recur over a time interval of at least two consecutive years
during which patients are symptomatic at least half of the time and are
not symptom free for more than two consecutive months
symptoms cause significant distress or psychosocial impairment at
some point
symptoms are now the direct result of a substance or another medical
condition
,Give this one a go later!
Cyclothymic Management Cyclothymic Disorder Description
Bipolar II Diagnostic Criteria Cyclothymic Diagnostic Criteria
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2 of 27
Definition
Mood stabilizers (lamotrigine, lithium, valproic acid, carbamazepine)
and/or second generation antipsychotics (quetiapine, aripiprazole,
olanzapine, risperidone)
Psychotherapy (cognitive, behavioral, interpersonal)
Good sleep hygiene recommended
Give this one a go later!
Bipolar II Management Cyclothymic Management
Bipolar I Management Bipolar I Acute Mania Treatment
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3 of 27
, Term
Bipolar I Impacts
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First line agents include:
Lithium (acute mania + long term management, decreased suicide risk)
Lamotrigine
Valproic Acid
(valproic acid + carbamazepine are also useful for rapid cycling or mixed features)
(lithium avoided in renal disease, valproate avoided in liver disease)
history of at least one major depressive episode and at least one hypomanic
episode
at least three symptoms affecting mood, thinking, or behavior
at least two years in adult, 1 year in adolescents
0.5% prevalence
Mood stabilizers (lamotrigine, lithium, valproic acid, carbamazepine) and/or second
generation antipsychotics (quetiapine, aripiprazole, olanzapine, risperidone)
Psychotherapy (cognitive, behavioral, interpersonal)
Good sleep hygiene recommended
1% of population
average onset is 20s-30s
new onset is rare after 50 years
more common in men
earlier the onset, the greater likelihood of psychotic features and the poorer
the prognosis
PEARLS 2026/2027 | STUDY GUIDE,
PRACTICE QUESTIONS, ANSWERS & EXAM
REVIEW
1 of 27
Definition
Characterized by at least two consecutive years of prolonged, milder
elevations and milder depressions in mood that do not meet the
criteria for either full hypomanic episodes or major depressive
episodes
one of more years in adolescent
criteria for mania never met
symptoms recur over a time interval of at least two consecutive years
during which patients are symptomatic at least half of the time and are
not symptom free for more than two consecutive months
symptoms cause significant distress or psychosocial impairment at
some point
symptoms are now the direct result of a substance or another medical
condition
,Give this one a go later!
Cyclothymic Management Cyclothymic Disorder Description
Bipolar II Diagnostic Criteria Cyclothymic Diagnostic Criteria
Don't know?
2 of 27
Definition
Mood stabilizers (lamotrigine, lithium, valproic acid, carbamazepine)
and/or second generation antipsychotics (quetiapine, aripiprazole,
olanzapine, risperidone)
Psychotherapy (cognitive, behavioral, interpersonal)
Good sleep hygiene recommended
Give this one a go later!
Bipolar II Management Cyclothymic Management
Bipolar I Management Bipolar I Acute Mania Treatment
Don't know?
3 of 27
, Term
Bipolar I Impacts
Give this one a go later!
First line agents include:
Lithium (acute mania + long term management, decreased suicide risk)
Lamotrigine
Valproic Acid
(valproic acid + carbamazepine are also useful for rapid cycling or mixed features)
(lithium avoided in renal disease, valproate avoided in liver disease)
history of at least one major depressive episode and at least one hypomanic
episode
at least three symptoms affecting mood, thinking, or behavior
at least two years in adult, 1 year in adolescents
0.5% prevalence
Mood stabilizers (lamotrigine, lithium, valproic acid, carbamazepine) and/or second
generation antipsychotics (quetiapine, aripiprazole, olanzapine, risperidone)
Psychotherapy (cognitive, behavioral, interpersonal)
Good sleep hygiene recommended
1% of population
average onset is 20s-30s
new onset is rare after 50 years
more common in men
earlier the onset, the greater likelihood of psychotic features and the poorer
the prognosis
