NR 547 Final Exam 2025/2026 | Chamberlain
College | Differential Diagnosis in Psychiatric-
Mental
What does a score of 0-7 on the Hamilton Depression Rating Scale (HAM-D)
indicate? - answer-Normal (no depression)
What does a score of 8-16 on the Hamilton Depression Rating Scale (HAM-D)
indicate? - answer-Mild depression
What does a score of 17-23 on the Hamilton Depression Rating Scale (HAM-D)
indicate? - answer-Moderate depression
What does a score of 24 or higher on the Hamilton Depression Rating Scale (HAM-
D) indicate? - answer-Severe depression
How are items on the Hamilton Depression Rating Scale (HAM-D) scored? -
answer-Each item is scored 0-2 or 0-4, depending on severity.
What type of tool is the Hamilton Depression Rating Scale (HAM-D)? - answer-A
clinician administered tool used to assess the severity of depression symptoms.
What aspects of depression does the Hamilton Depression Rating Scale (HAM-D)
evaluate? - answer-Psychological and physical aspects of depression.
,Presences of at least 2 additional symptoms (along with depressed mood) for a
diagnosis of PDD - answer-Poor appetite or overeating
Insomnia or hypersomnia
Low energy or fatigue
Low self-esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness
Symptom Consistency criteria for PDD - answer-No symptom free periods lasting
more than 2 months at a time during a 2 year period
Exclusion of Major depressive episodes - answer-A MDE may overlap, but PDD
cannot be diagnosed if the patient has had recurrent major depressive episodes
with symptom free periods longer than 2 months
,No History of Mania or Hypomania in PDD - answer-If a person has had a manic,
hypomanic, or cyclothymic episodes, PDD is not diagnosed (consider Bipolar
Disorders instead)
Symptom impairment in PDD - answer-Must interfere with work, school,
relationships, or daily life.
Time frame for PDD symptoms to make a diagnosis - answer-Adults: 2+ years of
chronic depressive symptoms
Children/Adolescents: 1+ year of symptoms
No symptom free period longer than 2 months
Clinical Importance of PDD - answer-PDD is more chronic but less severe than
Major Depressive Disorder
Often goes undiagnosed due to its persistent, low grade nature
Treatment for PDD - answer-CBT, SSRIs, SNRIs, lifestyle interventions
Augmenting Antidepressants: EB strategies - answer-When a patient partially
responds or does not fully respond to an antidepressant, augmentation strategies
can enhance effectiveness. Augmentation is especially useful in treatment-
resistant depression (TRD) or incomplete symptom relief.
, Optimize the current antidepressant - answer-Before augmenting, ensure:
Adequate dose and duration (ex: at least 6-8 weeks at a therapeutic dose)
Good adherence to medication regimen
Minimization of side effects
If symptoms persist, consider dose adjustment before adding a second agent.
Augmentation Strategies - answer-A. Add a second antidepressant (dual
mechanism approach)
B. Add an atypical antipsychotic (for treatment-resistant depression and MDD
with psychotic features
C. Add a Mood stabilizer (especially for bipolar cases)
D. Add a Dopaminergic or Stimulant Medication (for low energy, apathy, or
cognitive symptoms)
E. Add a hormonal or Nutritional Support (helpful in patients with subclinical
hypothyroidism)
SSRI+Buproprion (Wellbutrin) - answer-boosts energy and motivation, reduces
sexual side effects
College | Differential Diagnosis in Psychiatric-
Mental
What does a score of 0-7 on the Hamilton Depression Rating Scale (HAM-D)
indicate? - answer-Normal (no depression)
What does a score of 8-16 on the Hamilton Depression Rating Scale (HAM-D)
indicate? - answer-Mild depression
What does a score of 17-23 on the Hamilton Depression Rating Scale (HAM-D)
indicate? - answer-Moderate depression
What does a score of 24 or higher on the Hamilton Depression Rating Scale (HAM-
D) indicate? - answer-Severe depression
How are items on the Hamilton Depression Rating Scale (HAM-D) scored? -
answer-Each item is scored 0-2 or 0-4, depending on severity.
What type of tool is the Hamilton Depression Rating Scale (HAM-D)? - answer-A
clinician administered tool used to assess the severity of depression symptoms.
What aspects of depression does the Hamilton Depression Rating Scale (HAM-D)
evaluate? - answer-Psychological and physical aspects of depression.
,Presences of at least 2 additional symptoms (along with depressed mood) for a
diagnosis of PDD - answer-Poor appetite or overeating
Insomnia or hypersomnia
Low energy or fatigue
Low self-esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness
Symptom Consistency criteria for PDD - answer-No symptom free periods lasting
more than 2 months at a time during a 2 year period
Exclusion of Major depressive episodes - answer-A MDE may overlap, but PDD
cannot be diagnosed if the patient has had recurrent major depressive episodes
with symptom free periods longer than 2 months
,No History of Mania or Hypomania in PDD - answer-If a person has had a manic,
hypomanic, or cyclothymic episodes, PDD is not diagnosed (consider Bipolar
Disorders instead)
Symptom impairment in PDD - answer-Must interfere with work, school,
relationships, or daily life.
Time frame for PDD symptoms to make a diagnosis - answer-Adults: 2+ years of
chronic depressive symptoms
Children/Adolescents: 1+ year of symptoms
No symptom free period longer than 2 months
Clinical Importance of PDD - answer-PDD is more chronic but less severe than
Major Depressive Disorder
Often goes undiagnosed due to its persistent, low grade nature
Treatment for PDD - answer-CBT, SSRIs, SNRIs, lifestyle interventions
Augmenting Antidepressants: EB strategies - answer-When a patient partially
responds or does not fully respond to an antidepressant, augmentation strategies
can enhance effectiveness. Augmentation is especially useful in treatment-
resistant depression (TRD) or incomplete symptom relief.
, Optimize the current antidepressant - answer-Before augmenting, ensure:
Adequate dose and duration (ex: at least 6-8 weeks at a therapeutic dose)
Good adherence to medication regimen
Minimization of side effects
If symptoms persist, consider dose adjustment before adding a second agent.
Augmentation Strategies - answer-A. Add a second antidepressant (dual
mechanism approach)
B. Add an atypical antipsychotic (for treatment-resistant depression and MDD
with psychotic features
C. Add a Mood stabilizer (especially for bipolar cases)
D. Add a Dopaminergic or Stimulant Medication (for low energy, apathy, or
cognitive symptoms)
E. Add a hormonal or Nutritional Support (helpful in patients with subclinical
hypothyroidism)
SSRI+Buproprion (Wellbutrin) - answer-boosts energy and motivation, reduces
sexual side effects
