VERIFIED CORRECT ANSWERS
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The episode is not attributable to the physiological effects of a substance or to another medical
condition.
The occurrence of the major depressive episode is not better explained by schizoaffective
disorder, schizophrenia, schizophreniform disorder, delusional disorde
What are some common sleep disturbances experienced by patients with MDD? - CORRECT
ANSWER-Insomnia, hypersomnia.
What psychomotor changes would the clinician see when interviewing a patient with MDD? -
CORRECT ANSWER-Psychomotor retardation is the most common.
Psychomotor agitation is also seen, especially in older patients.
Agitation: Hair pulling, hand-wringing.
Stooped posture; no spontaneous movements; and a downcast, averted gaze.
Symptoms of psychomotor retardation may appear identical to patients with catatonic
schizophrenia.
,What is the prevalence of MDD? How do sex and age of the patient impact these rates? -
CORRECT ANSWER-Prevalence of 5-17%.
Twofold greater prevalence of major depressive disorder in women than in men.
The mean age of onset for major depressive disorder is about 40 years, with 50 percent of all
patients having an onset between the ages of 20 and 50 years.
What is the risk of suicide for patients with MDD? - CORRECT ANSWER-About 10 to 15 percent
of all depressed patients commit suicide, and about two-thirds have suicidal ideation.
18. What are the difficulties in recognizing depression in the elderly population? - CORRECT
ANSWER-Elderly people often have various co-morbid medical disorders that may have similar
symptoms to depression.
19. What are some common Differential diagnosis when considering MDD? - CORRECT
ANSWER-Table 8.8-1
20. How does the clinician differentiate MDD from Bipolar Disorder? - CORRECT ANSWER-
Episodes of mania-like symptoms, indicating bipolar I disorder (complete manic and depressive
syndromes), bipolar II disorder (recurrent major depressive episodes with hypomania),
21. What are some psychosocial therapies for the treatment of MDD? - CORRECT ANSWER-
cognitive therapy, interpersonal therapy, and behavior therapy
22. How does transcranial magnetic stimulation work? - CORRECT ANSWER-Short pulses of
magnetic energy stimulate nerve cells in the brain.
Used in adult patients who have failed to achieve satisfactory improvement from
antidepressants.
Produces focal secondary electrical stimulation of targeted cortical regions.
, It is nonconvulsive, requires no anesthesia, has a safe side effect profile, and is not associated
with cognitive side effects.
40-minute outpatient procedure that is prescribed by a psychiatrist and performed in a
psychiatrist office. The treatment is typically administered daily for 4 to 6 weeks. The most
common adverse event related to treatment was scalp pain or discomfort. TMS therapy is
contraindicated in patients with implanted metallic devices or nonremovable metallic objects in
or around the head.
23. What are the indications for Phototherapy? - CORRECT ANSWER-Seasonal disorders, sleep
disorders.
24. What are the pharmacotherapeutic options in treating MDD? How long should
pharmacotherapy last? How does the clinician select the best medication for treating MDD?
What are the reasons some patients experience treatment failure? - CORRECT ANSWER-SSRIs,
SNRIs, MAOIs, Tricyclics, atypical antidepressants.
Should last at least six months, or the duration of the depressed episode.
Selection of the initial treatment depends on the chronicity of the condition, course of illness (a
recurrent or chronic course is associated with increased likelihood of subsequent depressive
symptoms without treatment), family history of illness and treatment response, symptom
severity, concurrent general medical or other psychiatric conditions, prior treatment responses
to other acute phase treatments, potential drug-drug interactions, and patient preference.
(1) they cannot tolerate the side effects, even in the face of a good clinical response; (2) an
idiosyncratic adverse event may occur; (3) the clinical response is not adequate; or (4) the
wrong diagnosis has been made.